SOCIAL AFFAIRS POLICY REVIEW COMMITTEE SECOND ...

PP 2016/0098

SOCIAL AFFAIRS POLICY REVIEW

COMMITTEE

SECOND REPORT FOR THE SESSION

2015-16

Progress with Inquiries

REPORT OF THE

SOCIAL AFFAIRS POLICY REVIEW COMMITTEE

SECOND REPORT FOR THE SESSION 2015-2016

There shall be three Policy Review Committees which shall be Standing Committees

of the Court. They shall scrutinise the implemented policies, as deemed necessary by

each Committee, of the Departments and Offices indicated in this paragraph

together with the associated Statutory Boards and other bodies:

Social Affairs Committee: Department of Health; Department of Education

and Children; Department of Social Care; and Department of Home

Affairs.

Each Policy Review Committee shall in addition be entitled to take evidence from

witnesses, whether representing a Department, Office, Statutory Board or other

organisation within its remit or not, in cases where the subject matter cuts across

different areas of responsibility of different Departments, Offices, Statutory Boards or

other organisations. The Policy Review Committees may also hold joint sittings for

deliberative purposes or to take evidence. The Chairmen of the Policy Review

Committees shall agree on the scope of a Policy Review Committee’s inquiry where

the subject cuts across the respective boundaries of the Policy Review Committees’

remits.

Each Policy Review Committee shall have –

(a) a Chairman elected by Tynwald,

(b) two other Members.

Members of Tynwald shall not be eligible for membership of the Committee, if, for

the time being, they hold any of the following offices: President of Tynwald, member

of the Council of Ministers, member of the Treasury Department referred to in section

1(2)(b) of the Government Departments Act 1987.

The Policy Review Committees shall be authorised in terms of sections 3 and 4 of the

Tynwald Proceedings Act 1876 as amended and of Standing Orders to take evidence

and to summon the attendance of witnesses and further to require the attendance of

Ministers for the purpose of assisting the Committee (or Committees, if sitting

jointly).

The powers, privileges and immunities relating to the work of a committee of

Tynwald are those conferred by sections 3 and 4 of the Tynwald Proceedings Act

1876, sections 1 to 4 of the Privileges of Tynwald (Publications) Act 1973 and

sections 2 to 4 of the Tynwald Proceedings Act 1984.

Committee Membership

Mr D C Cretney MLC (Chairman)

Mr G G Boot MHK (Glenfaba)

The Hon S C Rodan SHK (Garff)

Copies of this Report may be obtained from the Tynwald Library, Legislative

Buildings, Finch Road, Douglas IM1 3PW (Tel 01624 685520, Fax 01624 685522) or

may be consulted at www.tynwald.org.im

All correspondence with regard to this Report should be addressed to the Clerk of

Tynwald, Legislative Buildings, Finch Road, Douglas IM1 3PW.

Table of Contents

I. INTRODUCTION ............................................................................................. 1

II. PUBLIC SECTOR RENTS ................................................................................... 3

III. PROVISION OF BREAST CARE ......................................................................... 5

IV. PUPIL DATABASE ........................................................................................... 6

V. PRE-SCHOOL EDUCATION ............................................................................. 11

REGULATIONS (RECOMMENDATION 2) 12

ADDITIONAL NEEDS (RECOMMENDATION 4) 13

ACCESS (RECOMMENDATION 5) 15

VI. OVERHAUL OF EDUCATION LEGISLATION ...................................................... 16

VII. IDENTIFICATION CHECKS AT PORTS ............................................................... 18

VIII. CONSOLIDATED LIST OF CONCLUSIONS AND RECOMMENDATIONS ............... 20

ANNEX : ORAL EVIDENCE HEARD, 2012 TO 2016 ................................................... 22

ORAL EVIDENCE ................................................................................................... 25

21ST JUNE 2011 EXTRACT FROM HANSARD OF TYNWALD COURT: “BREAST CARE APPOINTMENT OF

DEDICATED SPECIALIST SURGEON” AMENDED MOTION CARRIED 27

17TH SEPTEMBER 2014 EVIDENCE OF HON. R H QUAYLE MHK, MINISTER; MR M CHARTERS, CHIEF

EXECUTIVE OFFICER; AND MRS M MORRIS, EXECUTIVE DIRECTOR FOR HEALTH, DEPARTMENT OF HEALTH

AND SOCIAL CARE 65

31ST MARCH 2015 HOUSE OF KEYS ORAL QUESTION: WHAT POLICY OPTIONS HAVE BEEN (A)

CONSIDERED AND (B) AGREED IN RESPECT OF MEANS TESTING? 107

15TH OCTOBER 2015 EVIDENCE OF HON. T M CROOKALL MLC, MINISTER, AND PROF. R BARR, CHIEF

EXECUTIVE OFFICER, DEPARTMENT OF EDUCATION AND CHILDREN 113

12TH NOVEMBER 2015 EVIDENCE OF HON. J P WATTERSON MHK, MINISTER, AND MR M KELLY, CHIEF

EXECUTIVE OFFICER, DEPARTMENT OF HOME AFFAIRS 141

13TH APRIL 2016 EVIDENCE OF HON. T CROOKALL MLC, MINISTER, AND PROF. R BARR, CHIEF

EXECUTIVE, DEPARTMENT OF EDUCATION AND CHILDREN 163

WRITTEN EVIDENCE ........................................................................................... 187

APPENDIX 1: LETTER FROM MARK CHARTERS 12TH FEBRUARY 2015 – POSTION OF DEPARTMENT

REGARDING MEANS TESTING FOR PUBLIC SECTOR RENTS 189

APPENDIX 2: TYNWALD WRITTEN ANSWER 45 OF 13TH DECEMBER 2011 201

APPENDIX 3: LETTER FROM CHAMBER OF COMMERCE 9TH DECEMBER 2015 – INFORMATION REGARDING

IDENFICATION CHECKS AT PORTS 205

APPENDIX 4: EMAIL FROM THE MINISTER OF HOME AFFAIRS 15TH FEBRUARY 2016 - IDENFICATION

CHECKS AT PORTS 209

1

To: The Hon Clare M Christian, President of Tynwald,

and the Hon Council and Keys in Tynwald assembled

REPORT OF THE


SECOND REPORT FOR THE SESSION 2015-2016

PROGRESS WITH INQUIRES

I. INTRODUCTION

1. This Report contains details of the work of the Social Affairs Policy Review

Committee since its creation in 2011.

2. The Committee was created as part of the system of scrutiny committees established

by resolution of Tynwald in January 2011, with members first being elected to the

committees in November 2011 and meetings commencing in February 2012. The

Committee’s role is to scrutinise the implemented policies of the Department of

Education and Children, the Department of Health and Social Care, and the

Department of Home Affairs. Standing Orders allow the Committee flexibility in how

it goes about this role, stating that scrutiny must be undertaken “as deemed

necessary by each Committee”. Within this remit, the Committee is entitled to take

evidence, both oral and written.

3. The Committee originally had four Departments to scrutinise: the Department of

Education and Children, the Department of Health, the Department of Home Affairs

and the Department of Social Care. Following the 2014 restructuring of government

we now have only three Departments but the range of policy areas covered is as

wide as ever.

2

4. Mrs Cannell was elected Chair of the Committee in November 2011 and Mr Speaker

was also elected to the Committee at that time. The third member elected to the

Committee in November 2011 was Mr Juan Turner MLC. He was succeeded in May

2012 by Mr David Callister MLC, who was in turn succeeded in May 2013 by Mr Alan

Crowe MLC. Mr Crowe retired from the Legislative Council on 28th February 2015.

Mr David Cretney MLC was elected to the Committee on the 19th May 2015. Mr

Cretney was elected Chair of the Committee in October 2015 to replace Mrs Brenda

Cannell MHK. Mr Geoffrey Boot MHK was elected to the Committee in October

2015.

5. The Committee has produced seven substantive reports, namely:

First Report 2012/13: Centralised Pupil Database, PP 0015/13

Second Report 2012/13: The Centralised Pupil Database: Supplementary

Report, PP 0116/13

First Report 2013/14: The Provision of Breast Care, PP 0159/13

Second Report 2013/14: The Centralised Pupil Database Further

Supplementary Report PP 0178/13

Third Report 2013/14: Pre School Education, PP2014/0027

First Report 2014/15: Over-Referral and Under-Preparedness,

PP 2015/0049(1)-(2)

First Report for the Session 2015/2016 Social Care Procurement,

PP 2016/0072

6. A report on our investigation into Children and Families Services will be laid in this

session.

7. The Committee has taken oral evidence on 28 occasions. Some of these sessions

were arranged to pursue particular investigations, while others were general

sessions providing an opportunity for wide-ranging and direct scrutiny of the

Department concerned. Further details are at Annex 1.

8. The Public Accounts Committee agreed on 4th September 2012 to forward Internal

Audit Reports relating to the Committee’s Departments to the Committee as a

matter of routine. These reports, together with direct correspondence with the

3

Departments, give the Committee an opportunity to scrutinise the work of the

Departments without having to bring them to give oral evidence in public.

II. PUBLIC SECTOR RENTS

9. Our interest in this topic was sparked by a substantial rise in rent for Public Sector

Housing. In 2011 Mr Robertshaw, Minister for the Department of Social Care at the

time, announced a rise in Public Sector Rents. On the 2nd December 2011 the

Department of Social Care announced that Public Sector Rents would rise by 10% by

April 2012. He said:

Public sector housing is a vital part of the Island’s housing stock, helping to

provide thousands of families, older people and others in our community with

affordable, high-quality homes. It is vital that this remains the case. However,

the costs to the taxpayer of the existing housing stock have risen rapidly in

recent years and are forecast to continue to do so. This rent rise is an essential

first step to address the issue of providing affordable housing at a sustainable

cost. All of the evidence shows we must act now to ensure current and future

generations can access the affordable housing they need at a cost to tenants

and taxpayers that is both affordable and sustainable. 1

10. In November 2012 the Minister announced another rise in public sector rents due to

inflation and also that the rent charging system would be means tested.2

11. In December 2013 the Minister announced another increase in public sector rents

and at the same time made a reference to means testing:

The rent increase of 5% this year is to appreciate the impact of significant

increases over the last two years, whilst accepting there is a need to reduce the

financial impact on the Tax payer of Public Sector Housing provision. As

previously announced, my Department will be progressing with means tested

1 “Public sector rents to rise by 10% by April 2012”, Isle of Man Government Website, 2

nd December

2011 https://www.gov.im/news/2011/dec/02/public-sector-rents-to-rise-by-10-from-april-2012/ 2 “ A fair public sector rent rise”, Isle of Man Government Website, 12

th November 2012,

https://www.gov.im/news/2012/nov/12/a-fair-public-sector-rent-rise/

4

rents from 2015. This will provide a mechanism for an equitable rent that

reflects both the property and a tenant’s ability to pay.3

12. In September 2014 in an oral evidence session with the Hon. R H Quayle MHK the

Minister for Health and Social Care, the Caairliagh inquired about means testing for

public sector rents:

In December 2013, Minister, the then Minister for Social Care, Mr Robertshaw,

said the Department would be progressing with means tested rents for public

sector housing from 2015, before any further increases were going to be

brought in for public sector housing tenants. Bearing in mind that these tenants

have already had something like a 30% increase in rent over the last couple of

years, plus the introduction of the ‘toilet tax’ and now we have had an

announcement that gas is going to be increased, can I ask you what progress is

being made in terms of bringing in this vital measurement tool – means

testing?

13. The Minister replied:

The original introduction date of April 2015 has been deferred following

extensive research into the feasibility of introducing means tested rents for the

public sector. The current position regarding legislation and information

sharing has confirmed it is not possible to achieve the original 2015 timescale.

Following the feasibility study completed within my new Department of Health

and Social Care, it is clear that there is a need for more appropriate legislative

powers to be progressed before means testing rents can take place. It is

important that any policy we introduce is understood by the user, robust

enough to prevent fraud or loopholes and does not have unforeseen

consequences for the vulnerable. Work is ongoing to determine the strategic

policy on means testing across Government, to which my officers are

contributing. In the meantime, my Department will be consulting with all local

housing authorities to seek their views on the annual rent increase for 2015-16

and this will be progressed by the Department in the usual manner. A

statement on agreed rent increases for the sector will be made in November as

per usual.4

3 “Public sector rents to rise by 5% by 5

th April 2014”, Isle of Man Government Website, 16

th

December 2013, https://www.gov.im/news/2013/dec/16/public-sector-rents-to-rise-by-5-from-april-

2014/ 4 Q37 17

th September 2014

5

14. In December 2014 Public Sector Rents rose by 5% starting in April 2015.5

15. In February 2015 it was confirmed to the Committee that the Department of Health

and Social Care did not have the vires to carry out means testing for Public Sector

Housing. If they wanted to implement means testing they would have to have the

necessary legislation. 6

16. We then heard nothing for over a year. During the preparation of this report we

were advised that the Council of Ministers had decided in March 2015 to introduce a

central means testing system with corporate rather than departmental oversight. It

had also been decided that the policy would be determined by the Social Policy and

Children’s Committee.7

We conclude that the Minister for Social Care should have been aware of

the vires needed for means testing before announcing a date for the

implementation of this controversial policy.

Recommendation 1

That any future policy initiatives relating to means testing should be subject

to scrutiny by Tynwald and its Committees.

III. PROVISION OF BREAST CARE

17. Our investigation into the provision of breast care arose from the Tynwald sitting on

the 21st June 2011, when Tynwald debated the following motion:

That Tynwald is of the opinion that a dedicated Consultant Breast Care surgeon

should be appointed rather than a general surgeon with an interest in breast.8

18. The motion was amended in debate and the resolution ultimately agreed to was:

That Tynwald supports the Department of Health ensuring that the Breast Care

Service is maintained and enhanced to ensure that there is no diminution in the

present level of service provided within the Island, and supports the

5 “Public sector housing rents to rise by 5% by 5

th April 2015”, Isle of Man Government Website, 5

th

December 2014, https://www.gov.im/news/2014/dec/05/public-sector-housing-rents-to-rise-by-5-

from-april-2015/ 6 Appendix 1

7 Item 1.4

8 Item 49

6

Department continuing to provide a dedicated breast care service led by a

surgeon specialising in breast surgery, thereby securing the service provided to

patients and refers the matter of the provision for breast care to the Social

Affairs Committee, with an instruction that it report on this matter at the

earliest opportunity to ensure that the Department has maintained and

enhanced the provision of the breast care service and complied with the

Minister’s public commitments.

19. The Minister’s public commitments referred to in the resolution are those given by

Hon David Anderson MHK during the course of the debate.

Services will be enhanced, not downgraded... the breast care service available

on the Island will not only be as good as it is now under the current locum … but

the post will be enhanced as follows … The first phase is to appoint a dedicated

breast care surgeon to the post; phase 2 is then to introduce a sentinel node

biopsy service; and phase 3 is to offer on-Island breast reconstruction.

20. In November 2013 we wrote “The First Report for the Session 2013-14: The Provision

of Breast Care” on whether the breast services in general had been enhanced; and

whether the three phases identified by the Minister have been delivered. The Report

was based on written evidence; and also on the relevant parts of the oral evidence

of the Minister and Chief Executive given on 9th July 2012.

21. In this report all three phases of the Department of Health’s plan for breast care

were outlined and it was concluded that the Department had delivered all three

phases of its plan as outlined by the Minister.

We conclude that the Department of Health did deliver on their provision

of breast care plan as we did monitor the situation closely.

Recommendation 2

That the Department continue to enhance the surgical services on the Isle

of Man to ensure that the residents get the best care.

IV. PUPIL DATABASE

22. We decided to investigate the centralised pupil database following our general oral

evidence session with the Department of Education and Children on 2nd May 2012. A

centralised pupil database was put in place by the Department of Education and

Children in 2011 to 2012.

7

23. The set-up cost of the centralised pupil database system was £267,000 and the

annual running cost is estimated at £44,000. 9

24. The purpose of the system was to assist the Department in managing its services. As

the Department portrayed in December 2011:

Currently, the Department is reliant upon individual schools to supply limited,

decontextualized data to the Department. This is gathered in sections, e.g. we

have month by month attendance data by school and we have attainment data

by cohort in each school. This allow us to take some very generalised views of

quality and outcomes, but does not, for example, allow us to investigate and

intervene across the piece on the impact of attendance on achievement, cohort

and school differences etc. The database will also allow us to make evidence

based decisions on the effectiveness of provision for a range of groups, e.g.

looked after children, children with disabilities, low level SEN [Special

Educational Needs], youngest children in cohort, achievement of pupils with

entitlement to free school meals etc. We have struggled to make evidence

based decisions other than at single school level and have not been able to set

policy based on evidence as well as we could.10

25. Our principal concern relating to the centralised pupil database related to the

handling of personal data and whether the arrangements which have been put in

place comply with the obligations of the Department of Education and Children, and

of head teachers, under data protection legislation.

26. After the 2012 oral evidence session we obtained written advice and a private

briefing from the Data Protection Supervisor; comparative information on other

jurisdictions compiled by the Tynwald Information Service; and a paper from Mr

Tristram Llewelyn-Jones outlining certain policy concerns.

27. The advice we have received from the Data Protection Supervisor, was that each

head teacher is a separate "data controller" for the purposes of data protection

legislation, separate and distinct from each other and from the Department

centrally. Head teachers have express duties under primary and secondary

legislation to submit some pupil information to the centre, but not all such

information. Hence the Supervisor concluded:

9 PP 2013/0015

10 Appendix 2

8

With regard to the second [data protection] principle, it is the duty of the data

controller to ensure that personal data is only processed for the specified and

lawful purpose for which that data was obtained. Again, it would be for the

Court to determine but it seems that the Regulations [i.e., the Education Act

(Registration of Pupils) Regulations 2004] do not provide for the head teacher

to provide to DEC all the personal data in the attendance and admission

registers and therefore such disclosures may contravene the second principle.11

28. It therefore appeared that there was a risk that the DEC could be found to be holding

information to which it is not legally entitled. It follows that if the Centralised Pupil

Data System has been developed and the information is not being lawfully processed

by DEC then there is also a question as to whether the existing legal framework in

the Isle of Man provides sufficient protection to individuals. Given these alarming

findings of the Data Protection Supervisor, we wrote a report and submitted our

findings.

29. In January 2013 we reported in the “First Report of the Social Affairs Policy Review

Committee for 2012/13: Centralised Pupil Database” and we made the following

recommendations regarding the centralised pupil database:

Recommendation 1: That Tynwald considers an eight-month delay in providing

a substantive response to a request by a parliamentary committee for a

specified document to be completely unacceptable.

Recommendation 2: That work on the centralised pupil database should be

halted until the necessary legislative framework is in place.

Recommendation 3: That before it puts any updated legislative framework for

the handling of pupil data before Tynwald for approval, the Department of

Education and Children should undertake thorough consultation with Tynwald

Members, parents, teachers and other interested parties.

Recommendation 4: That the Council of Ministers should ensure that

legislation to strengthen the enforcement powers of the Data Protection

Supervisor is introduced as soon as possible taking into account international

developments.

30. The Report of this Committee on the Centralised Pupil Database was laid before

Tynwald in February 2013. In April it was debated and only Recommendation 1

11 PP 0015/13

9

passed as it appeared in the report. Recommendation 3 failed to carry.

Recommendation 2 and 4 were amended:

Recommendation 2: That Tynwald is of the opinion that the necessary

framework is in place for work on Centralised Pupil Database to continue.

Recommendation 4: That the Council of Ministers continues to review data

protection legislation to ensure that it remains consistent with international

standards.

31. The Department of Education and Children produced a written response which was

laid on 16th April 2013, on which date the Committee’s Report and the Government’s

response were debated together.

32. HM Acting Attorney General contributed to the debate on 16th April 2013. The

Members of the Committee at that time felt that his contribution left some

questions unanswered. After the debate the Committee therefore put those

questions to him in writing. He responded with a written Advice Note which we

published in our Centralised Pupil Database: Supplementary Report in July 2013.12

33. In December 2013 the Acting Attorney General and the Data Protection Supervisor

wrote in a joint statement which we reported on in our Centralised Pupil Database:

Further Supplementary Report.

34. We recommended in this report that:

That regulations under section 16 of the Education Act 2001 be brought

forward without delay.

35. The Recommendation was approved by Tynwald in the April sitting 2014.

36. Since our reports, the Centralised Pupil Database shut down in October 2015 due to

lack of vires. The Department of Education and Children said at the time that it

hoped new secondary legislation would be introduced subject to approval in

Tynwald which would allow the Department to start the Centralised Pupil Database

again.

12 PP 2013/0116

10

37. At the Tynwald sitting of February 2016 the Education (Registration of Pupils)

Regulations 2016 were approved.13

38. On the 13th April 2016 the Committee asked the Minister of Education and Children

about the Centralised Pupil Database after the approval of the Education

(Registration of Pupils) Regulations 2016.

39. The Minister replied:

That, as we know, was turned on after I came back to Tynwald a couple of

months ago. As a result of that coming back in now, certainly the educational

psychologists have access to the information –and they were the ones that

were most hard done by while that was turned off, while we were resolving the

issue. It does mean that we have access back to the information that we need –

albeit in numerical terms and not by names –and we were getting before for

the Department’s benefit. 14

40. The Committee investigated further by asking:

Can I just ask you to confirm that the regulations governing providing

information to parents in respect of data held in schools is to be updated to

reflect the regulations passed this February in Tynwald, which gave the

authority and the legal powers to the Department actually to hold and collect

data that went beyond registration and admission: the new central pupil

database, in effect.15

41. The Minister confirmed that the Education (Registration of Pupils) Regulations 2004

would be updated to ensure that parents of the children would be able to view the

information that was disclosed in the database. 16

We conclude that welcome improvements have been made to the statutory

framework underlying the pupil database as a result of the work of the

Committee.

Recommendation 3

13 SD 2016/0031

14 Q101, 13

th April 2016

15 Q102, 13

th April 2016

16 SD 2004/0432

11

That the Department of Education and Children should update the

Education (Registration of Pupils) Regulations 2004 by December 2016.

V. PRE-SCHOOL EDUCATION

42. The system of pre-school education was reformed in 2012. It was referred to us on

20th April 2012 by ten Tynwald Members. Their letter requested that we review the

Department of Education and Children’s policy on pre-school education, and

consider if the new policy is value for money and also if it meets educational needs.

On 27th April 2012 we issued a public call for evidence. We are grateful to everyone

who responded.

43. Our online consultation exercise of April to May 2013 gave us some information on

these matters, seen mainly from a parent’s point of view. The consultation told us

that the number of hours per week being received by each child showed a wider

spread than before, with some children being in an establishment as many as 45

hours per week and others as few as 2.5 hours per week. But it did not give us a clear

overview of the sector as a whole.

44. In February 2014 we published a report on pre-school education: “The Third Report

of the Social Affairs Policy Review Committee for the Session 2013/14: Pre-School

Education”17. This report was laid in the March and debated in May in Tynwald. The

following recommendations were made in the report. All of them were approved:

Recommendation 1: That Tynwald is of the opinion that, where a Department

or the Council of Ministers is contemplating a radical change in policy, the need

to consult Tynwald and the public is greater than ever; and that even if the

need for a change is driven by budgetary considerations, efforts should be

made to consult upon and debate the change outside the budget process.

Recommendation 2: That the Department of Education and Children should

work with the Department of Health and Social Care to consider regulation and

other means which will maximise the educational standards applicable where

pre-school establishments enjoy the benefit of public funding through the credit

scheme.

Recommendation 3: That the Department of Education and Children should

continue to produce baseline assessment data for new reception children, and

17 PP 2014/0027

12

that this information should be published annually together with a detailed

analysis of the reasons for any changes.

Recommendation 4: That the Department of Education and Children and the

Department of Health and Social Care should assess the impact of the 2012

pre-school reforms on the Government’s ability to identify children with special

educational needs, and report with recommendations on what action could be

taken in mitigation.

Recommendation 5: That the Department of Education and Children, with the

Treasury and the Department of Health and Social Care, must aim to design the

credit scheme and to allocate sufficient funds, to ensure that no child is denied

the opportunity of attending five 2.5 hour sessions per week throughout their

pre-school year.

45. Since the debate we have been monitoring the situation with regards to pre-school

education. In October 2015 during an oral evidence session we asked what had been

done about the recommendations that had not been completed.

Regulations (Recommendation 2)

46. The Tynwald Policy Decisions Report laid in October 2014 depicted that

recommendation 2 was ongoing;

The Department is actively considering best practice as identified by the British

Irish Council, in order to establish educational standards in conjunction with the

Department of Health & Social Care. 18

47. In an Oral Evidence session on the 15th October 2015 we asked:

One of the issues you referred to was pre-school education and, of course, the

educational standards for private and third sector providers was one of the

issues explored at length by Tynwald and by this Committee in its report to

Tynwald, in the context of the ending of preschool state-provided education –

albeit to half the children of the Island – and of course emphasis was given to

the fact that with now private providers stepping in across the board, there

would be education standards to be applied so that these establishments are

worthy of the name of pre-school education, not simply childminding services.

So the question really is: what has been done over the last three years to

establish and apply, in conjunction with the Department of Health and Social

18 GD 2014/0062

13

Care, those educational standards, which is something that you said you would

be doing? 19

48. The Minister said:

We are continuing to liaise closely with the Registration and Inspection Unit of

DHSC, Chairman. We have been invited – and it is purely by invitation only at

the moment – to go out with them and inspect, and that has been done. We

are working to change the legislation to make sure that is done and enshrined –

that we work together in the future, but at that moment it is purely by

invitation from DHSC to go out with them on those inspections.

49. In April 2016, in oral evidence we asked the Department if they had progressed with

educational standards. The Chief Executive replied:

We do have a number of initiatives that are on-going in terms of preschool

education. We are liaising very closely with the Registration and Inspections

Unit of Health and Social Care. That roughly takes place every half term. We

have reached agreement with DHSC in principle that joint inspections with both

Departments would be the right way forward. We have been looking at

leadership in terms of Registration and Inspections as well. We have a planned

training day organised by Department of Education and Children in May and

also by 200 the Education Improvement Service on early years, and that is going

to be led by former HMI inspectors in early years education. So we are trying

our best where we can, without having the legislative framework and the

statutory framework to do so, to try and engage in this space. 20

50. We observe the efforts that the Department of Education and the Department of

Health and Social Care are giving with regards to educational standards. We will

continue to monitor the Department’s efforts.

Additional Needs (Recommendation 4)

51. We received information from the Department of Education and Children regarding

identifying children with additional needs in response to our report. The Department

concluded:

The Department recognises the importance of identifying pupils with additional

needs, at an early stage, such that these needs can be promptly addressed. In

19 Q19, 15

th October 2015

20 Q86, 13

th April 2016

14

addition, it is also aware of existing mechanisms such as Health visitor

screening, referrals to the Pre-School Assessment Centre and the expertise and

experience of Reception class teachers in identifying special needs which do

much to identify the children suggested, within the report. Further, the

Department is aware of the Department of Health and Social Care’s Daycare

Standards (particularly Standard 10) which require settings to be aware that

some children may have special needs and be proactive in ensuring that

appropriate action is taken when such a child is identified. As indicated in

Recommendation 2 of the SAPRC’s report of May 2014, in order to go further

than this, however, the Department would require regulation to maximise

educational standards and we would anticipate this being enshrined in the new

Education Bill.21

52. The Tynwald Policy Decision Report laid in October 2014 depicted that

recommendation 4 was ongoing:

The Department recognises the need to identify children of pre-school age with

special educational needs, and will be discussing this issue with the Department

of Health & Social Care to ensure that such needs are identified by health

professionals. 22

53. In an oral evidence session on 15th October 2015 the Committee asked:

On special education needs, one of the specific recommendations in May of last

year by this Committee when it took the report to Tynwald was that: The

Department ... and the Department of Health and Social Care should assess the

impact of the 2012 pre-school reforms on the Government’s ability to identify

children with special educational needs, and report with recommendations on

what action could be taken in mitigation. So the question is: when do you

expect to report with any recommendations?23

54. The Chief Executive Officer replied:

That is something that Chrissie Callaghan is working on and we would

anticipate a report forthcoming ... I cannot give you an exact date. Again, I am

happy to provide that date outside the Committee. I cannot just remember off

the top of my head when exactly that would be, but Chrissie Callaghan has

21 GD 2014/0031

22 GD 2014/0062

23 Q26, 15

th October 2015

15

been doing a piece of work in that area. I know you had some discussions in

Government about some of this last week.

55. In April 2016, in oral evidence we asked if anything had been done regarding

identifying children with special educational needs. The Minister replied:

Yes. We have an arrangement with the preschools, Chairman, where they have

access to the Preschool Assessment Centre. If they think there are any issues,

they are more than welcome –in conjunction with the parents and the children

involved –to make use of that facility.24

Access (Recommendation 5)

56. In the Tynwald Policy Decision Report 2014 it was depicted that recommendation 5

was still ongoing.

57. In October 2015 we received oral evidence from the Minister and Chief Executive

Officer. We asked what was being done about pre-school education in deprived

areas where the private sector had no incentive to put pre-schools. The Chief

Executive replied:

Obviously, Government could incentivise, in some way, private sector providers

to also go into those areas. So it is a question of what policy we look at. What

we are not saying today is that we think that the system is perfect. There are

clearly issues that we are looking at, we will be reporting back on and it will

then be to determine what course of action we take to address those issues.25

58. In April 2016 in an oral evidence session we asked the Chief Executive Officer a

similar question about what was going to be done about preschool education in

areas that had no pre-schools. The Chief Executive replied:

I think there is an issue there, obviously. What we have seen is that the private

sector is taking the easier bits and the profitable bits, and that is fine. There is

an issue, when you talk about ‘deprivation’, I would suggest that it is the more

rural areas as well as potentially poorer areas, and it is how we manage that. I

think that is an issue for Government in the sense of perhaps incentivising the

private sector to do this. It is either that or you are then into a position of

potentially Government re-entering an area that it left to the private sector. So

either of those options, I would suggest, are political but I do not doubt that we

24 Q93, 13

th April 2016

25 Q29, 15

th October 2015

16

need a decision in this area because the current provision is not where we

would want it to be.26

59. We remain of the view that all the recommendations in the Tynwald Policy Decisions

Report should be adhered to and we look forward to the progression of standards of

pre-school education and identifying additional needs.

We conclude that there is important unfinished business by the

Department of Education regarding pre-school education.

Recommendation 4

That the Tynwald resolution of May 2014 concerning pre-school education

should be implemented in full before the end of the 2016/17 session.

VI. OVERHAUL OF EDUCATION LEGISLATION

60. Our interest in the new Education Act began in July 2015 when the Department of

Education asked Tynwald if the life of Education Council could be extended so

important legislation could be brought through. They said it would be the biggest

overhaul in legislation since the Education Act 2001. 27

61. The Minister for Education and Children said:

It would be beneficial if the Department is able to retain the current members

as their experience will be invaluable as we finalise the new structure.

62. The Minister of the Department of Education and Children did not bring the

Education Council (Amendment) Order 2015 to the July sitting of Tynwald.

63. In an oral evidence session of October 2015, the Committee asked the Minister why

he had postponed bringing in the order. The Minister said:

Yes, we are still reviewing it, Chairman. I was asked by a couple of Members if

we would go away – well, I was asked a couple of questions which put some

doubts in my mind but also, with Tynwald’s blessing, I was able to take that

away and have a look at it. We believe there are probably some savings to be

made – financial savings – but also some improvements that could be made to

26 Q95, 13

th April 2016

27 “Tynwald asked to extend life of education council”, Isle of Man Government Website, 9

th July 2015,

https://www.gov.im/news/2015/jul/09/tynwald-asked-to-extend-life-of-education-council/

17

the Education Council. So in discussion with Council over the summer period ... I

will be bringing that back to November.28

64. In the same oral evidence the Committee asked the Chief Executive why the new

Education Bill would be an overhaul of legislation.

Can I ask: why is such an overhaul necessary and what that is new is going to

be in legislation that is not currently in legislation? 29

65. The Chief Executive Professor Barr replied:

You asked about what we want within this legislation and why it is important.

There are a number of things. Special education needs is not covered properly

in the existing legislation. We need greater clarity in that area about the type

of entitlement ... the expectation that parents might have of what we can

provide in that area. It is very weak – the legislation in that area. We need to

really address the issue of the fact that it is very easy for somebody to set up an

educational establishment here on the Island. Some of you will remember the

hotel school in Port Erin and various other educational initiatives that have

been brought forward. The Department has no power to inspect those facilities

to determine the quality of the education and what has happened in the past

on more than one occasion is that those private providers have failed for one

reason or another and then Government, through the Education Department,

has then had to try and pick up that education provision. That has caused a lot

of disruption and distress to young people who, in good faith, have entered into

those educational arrangements and then either not got the qualifications that

they expected or got no qualifications at all. So we need something in the

legislation that provides us with a greater capacity as a Government, not

necessarily to stop private providers but to make sure that actually what they

are doing meets the standards that we would expect across the Island.

66. In oral evidence in April 2016 we asked how the Department were progressing with

the new legislation. The Minister replied that it will be in the parliamentary year of

2017-2018. 30

67. In the same oral evidence we asked if the new legislation would allow the

Department to inspect home-educators:

28 Q18, 15

th October 2015

29 Q14, 15

th October 2015

30 Q79 , 13

th April 2016

18

You talked about inspection of private institutions. Are there any plans to go

wider than that in ensuring parents carry out their duty of educating their

children?31

68. The Chief Executive Officer said there were no plans to do anything with those who

choose to home-educate their children apart from registration.

We conclude that the Department of Education should make sure that the

new Education Bill includes all the vires to regulate educational standards.

Recommendation 5

That the proposed Education Bill should have a very high priority in the

legislative programme after the General Election.

VII. IDENTIFICATION CHECKS AT PORTS

69. We have been examining the issue of identification checks since the Chief Constable

brought it to the attention of the public in October 2015. The Chief Constable

outlined the dangers of no verification of identification while on board the Steam

Packet ferry crossings from United Kingdom and Ireland to the Isle of Man.

70. In October 2015 the Minister for Home Affairs announced there would be a public

consultation:

Home Affairs Minister Juan Watterson announced he intends to consult on

travel ID proposals as the Chief Constable published his latest annual report

showing a 9 per cent increase in recorded crime32

71. In November 2015 the Minister for Home Affairs appeared in front of the committee

to give oral evidence and we asked about the announcement of the consultation

about the possibility of improving border security and the differences between sea

and air travel. The Minister replied:

Well, certainly at the moment an individual can turn up to the Sea Terminal or

at the UK end, buy a ticket with cash and not be required to give any

identification. He is required to give a name – and it could be any name, it is

31 Q90, 13

th April 2016

32 “Passport plan for boat journeys designed to cut crime”, Isle of Man Today Website, 9

th October

2015, http://www.iomtoday.co.im/news/isle-of-man-news/passport-plan-for-boat-journeys-

designed-to-cut-crime-1-7503264#ixzz43YEhpDxw

19

not checked, it is not verified - and then travel freely onto the Isle of Man, and

then potentially onwards to either Dublin or Belfast; or the other way round.

This means that the Police, looking at the list of names of people coming in on

the ferry for intelligence purposes, render that work entirely meaningless

because there is no way of verifying that at all. Turning to the Airport many

routes, but not all routes, require photo ID for domestic travel within the United

Kingdom; and certainly if you are taking in hold luggage that normally puts the

requirement in there for identification. We have also identified that for sea

travel between the United Kingdom and the Channel Islands there is a

requirement for ID; and likewise between Holyhead and Dublin there is a

requirement for ID. So even though these areas are all within the Common

Travel Area there is a requirement for identification.33

72. In December 2015, a letter from the Chair of the Isle of Man Chamber of Commerce

was received voicing their concerns about details of evidence delivered by the

Minister of the Department of Home Affairs:

It was reported recently that the Home Affairs Minister advised the Tynwald

Scrutiny Committee that ID checks are completed in the Channel Islands and

Ireland. Assuming this information to be correct, the Visitor Economy (VE)

Committee of the Isle of Man Chamber of Commerce have a number of

concerns. The Committee has not been consulted on this issue and we would

like to clarify that ferry services from the UK to the Channel Islands do not

require ID for travel. There is no requirement for passports to be checked for

border control purposes on any travel between the UK, IoM, Channel Islands, or

the Republic of Ireland. Indeed, there is no Government requirement for

passengers on these services to possess a passport.34

73. We received an email from Mark Woodward Chief Executive Officer of the Steam

Packet Company who confirmed the Chamber of Commerce’s comments that

stated that identification was not necessary travelling between the UK, Isle of Man,

Channel Islands or the Republic of Ireland.

74. We wrote a letter to the Department of Home Affairs asking if the Minister had been

misinformed about identification checks. The Minister replied:

33 Q9, 12

th November 2015

34 Appendix 3

20

It is correct to say that on some ferry routes in the British Isles ID is required, in

others ID is recommended, and in the case of one ferry Operator it depends

which route you are travelling as to whether it is a requirement or not.35

75. As the outcome of the Department’s consultation exercise is still awaited, we have

not drawn any conclusions on this matter for the moment.

We conclude that the new Committee should continue to monitor

developments of identification checks.

VIII. CONSOLIDATED LIST OF CONCLUSIONS AND RECOMMENDATIONS

76. We conclude that the Minister for Social Care should have been aware of the vires

needed for means testing before announcing a date for the implementation of this

controversial policy. (paragraph 16)

Recommendation 1

That any future policy initiatives relating to means testing should be subject

to scrutiny by Tynwald and its Committees.(paragraph 16)

77. We conclude that the Department of Health did deliver on their provision of breast

care plan as we did monitor the situation closely.(paragraph 21)

Recommendation 2

That the Department continue to enhance the surgical services on the Isle

of Man to ensure that the residents get the best care. (paragraph 21)

78. We conclude that welcome improvements have been made to the statutory

framework underlying the pupil database as a result of the work of the Committee.

(paragraph 41)

Recommendation 3

That the Department of Education and Children should update the

Education (Registration of Pupils) Regulations 2004 by December 2016.

(paragraph 41)

79. We conclude that there is important unfinished business by the Department of

Education regarding pre-school education. (paragraph 59)

35 Appendix 4

21

Recommendation 4

That the Tynwald resolution of May 2014 concerning pre-school education

should be implemented in full before the end of the 2016/17 session.

(paragraph 59)

80. We conclude that the Department of Education should make sure that the new

Education Bill includes all the vires to regulate educational standards. (paragraph 68)

Recommendation 5

That the proposed Education Bill should have a very high priority in the

legislative programme after the General Election. (paragraph 68)

81. We conclude that the new Committee should continue to monitor developments of

identification checks.(paragraph 75)

D C Cretney (Chairman)

G G Boot

S C Rodan

May 2016

23

ANNEX : ORAL EVIDENCE HEARD, 2012 TO 2016

02 May 2012 Department of Education and Children

21 Jun 2012 Pre-School Education

28 Jun 2012 Pre-School Education

09 Jul 2012 Department of Health

09 Oct 2012 Pre-School Education

24 Oct 2012 Department of Home Affairs

05 Nov 2012 Pre-School Education

03 Dec 2012 Department of Social Care

23 Jan 2013 Department of Health

27 Mar 2013 Department of Education and Children

17 Jul 2013 Department of Social Care

27 Nov 2013 Department of Home Affairs

29 Jan 2014 Over referral to Social Services

25 Jun 2014 Department of Education and Children

17 Sep 2014 Department of Health and Social Care


29 June 2015 Over Referral to Social Services

10 Sep 2015 Over Referral to Social Services

15 Oct 2015 Department of Education

24


07 Dec 2015 Social Care Procurement

27 Jan 2016 Social Care Procurement

27 Jan 2016 Department of Health and Social Care

13 Apr 2016 Social Care Procurement

13 Apr 2016 Department of Education and Children

11 May 2016 Personal Capability Assessment



25

ORAL EVIDENCE

27

21st June 2011 Extract from Hansard of

Tynwald Court: “Breast care

Appointment of dedicated specialist

surgeon” Amended motion carried

TYNWALD COURT, TUESDAY, 21st JUNE 2011

_________________________________________________________________ 1399 T128

Breast care Appointment of dedicated specialist surgeon

Amended motion carried

49. The Hon Member for Douglas East (Mrs Cannell) to move: That Tynwald is of the opinion that a dedicated consultant breast care surgeon should be appointed rather than a general surgeon with an interest in breast. The President: Thank you, Hon. Members. As I indicated before we took our break, we are taking, at this stage, Item 49 on the Order 3995

Paper, headed up ‘Consultant Breast Specialist’. I call the Hon. Member for Douglas East, Mrs Cannell, to move, please. Mrs Cannell: Thank you, Mr President. Also, can I put on the record my sincere appreciation at your agreement to be able to take the 4000

debate at this juncture in time, bearing in mind the extent of public concern. Mr President, I think, to be fair to the whole subject matter, I need to touch on a little bit of

history, before we get onto the substantive matter. It was back on 12th March 1996 in the House of Keys, a former Member of Tynwald, Mr Kniveton, asked the then Health Minister, ‘When do you intend to introduce screening for breast cancers in the Isle of Man?’ At that time, there was a 4005 mobile unit that visited the Island for the Marks & Spencer staff for screening, and also for the Isle of Man Post Office workers.

Needless to say, things eventually got to the floor of Tynwald. On 19th June 1996, Mr Kniveton moved:

4010 ‘that Tynwald is of the opinion that a National Health Service programme of breast screening be introduced within six months.’

That was in June 1996. At that time, it had been originally recommended by a Dr Jackson in 1978. At this point, there were 5,000 women who signed a petition, asking for breast screening to be 4015

introduced into the Isle of Man, and that was undertaken in 1995. During the debate on whether or not Tynwald should set up a breast screening programme, the Health Minister of the day, Mr May, indicated that in 1994, 21 Manx women had died of breast cancer, and so it will be no surprise to learn that, in fact, he was the Member that got up to his feet to second the motion that was moved by Mr Kniveton. There was a number of very interesting things came out of that debate. 4020

At that time, the petition and the Joint Women’s Council for the Isle of Man wholeheartedly supported the initiative and they, during those days, represented 11 organisations. Today, the Joint Women’s Council represents around 25 different women’s organisations, and it has grown from strength to strength. During that debate, the Hon. Member for Garff, Mr Rodan, gave a very well-informed contribution, particularly so, I think, in view of his medical background. He said, and I 4025 quote,

‘Experience in Britain has shown that of the 25,000 new cases of breast cancer, women who are treated in specialist centres by breast cancer experts survive longer than those treated in smaller hospitals by general surgeons.’ 4030

He was very right and I believe that is still the view today. On 15th October 1996, the Health Minister moved that Tynwald approve expenditure not

exceeding £106,000 to actually set up the breast screening and the Minister said at the time: ‘I would anticipate that the unit will be ready to receive its first clients by the beginning of April 1997.’ 4035 By 5th May 1998, we still did not have any breast screening recall service at all, despite the

fact that the Minister had promised it two years previously. In fact, breast screening recall did not start until the beginning of 2008. So Tynwald debated the policy in 1996, the money was approved several years later, but it was not until 2008 that it started. So, although it was supported by a 4040 unanimous vote during that time, it was very long in coming to pass.

There was also an offer at that time – well, in fact, it was more than an offer, it was a contribution that was made by the women’s organisations of quite a large sum of money to the Department towards the setting up of the breast screening and recall service for the Isle of Man. I think it would be fair to say they had to fight tooth and nail for this and it has taken an inordinate 4045 length of time to actually bring it to pass.

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Moving forward, Mr President, in the House of Keys on Tuesday, 23rd March 2010, a Question was raised by myself to the former Health Minister, Mr Teare, in respect of what arrangements are in place to provide breast reconstruction surgery for Island residents and how many residents require this surgery. He went on to say that there was a business case. He also 4050 dismissed it in the medium to long term by saying it will cost approximately £1 million to set up such a service.

Hon. Members, Mr President, why did I ask that Question? The reason I asked that Question was that, since the retirement of the general surgeon who had responsibility for breast surgery in the Isle of Man, Mr Clague, the Department had recruited a locum specialist breast surgeon and 4055 she has been in place for the last two years. She is highly skilled, highly trained and can do sentinel node biopsy – which is a very important part of breast surgery – and breast reconstruction work, and had performed three breast reconstructions on-Island for Island patients, but then management had stopped her from doing those. Presently, if anybody, a woman, needs or requires breast reconstruction, she has to go off to the UK, to the mainland. 4060

So it was stopped here, and I felt it was a nonsense that if we had recruited such a surgeon, albeit on a locum basis, and she had these skills, we ought to be utilising them because not only is it better for the patient – those who are able to have breast reconstruction at the same time as mastectomy, which many do – it also involves one procedure. It also maintains the contact with her family and often young children, and to the taxpayer in the Isle of Man, of course, it costs a lot 4065 less money, so it is more economical to offer breast reconstruction or some degree of breast construction on-Island. But at that time it was dismissed.

I followed it up the same year, when the new Minister was appointed, Mr Anderson, on 2nd November, and in the House of Keys, I asked him whether the Department had now considered the business case, which was referred to by the former Minister, to provide on-Island breast 4070 reconstruction surgery and what the outcome was. He replied that there would be a three-year strategy. In year 1, they would fund and appoint a consultant breast surgeon; year 2, introduce sentinel node biopsy service; and lastly, year 3, to provide breast reconstruction surgery on-Island.

Now, I was very, very pleased and I thought, obviously, the Department, being a responsible Department, had acknowledged the importance of this and everything was on course and how 4075 wonderful it was. The breast cancer patients were delighted. They assumed that now the services of the locum breast specialist would be made secure. Of course, that has not happened and did not happen in November 2010.

Anyway, Christmas came and it went. I followed that up with more Questions to the Minister, some in written form, asking him to explain to me what a delayed reconstruction was. He 4080 explained that it could be carried out weeks or even years later. Under the cancer code, if you like, the level, the standard at which the service has been operating at for the last two years, a lady who finds herself in the position where she has breast cancer,, and she has to have a mastectomy, should be automatically offered a breast reconstruction at the same time, at the same discussion as that which occurs when they are discussing surgery. It is done, but of course, the option is that it is 4085 delayed, so that you either have to wait until they are referred, or they have to wait until they finish their chemotherapy and/or radiotherapy and some ladies, once they get over that actual surgery and that operation, cannot bring themselves to face yet another operation and so many ladies are not opting for it and others are having to wait.

More questions were asked in terms of the costs. What did it cost for the three on-Island breast 4090 reconstruction procedures, vis-a-vis the ones that were performed in the United Kingdom. The Department said that in 2008-09 the three breast reconstruction procedures that were carried out in the United Kingdom was a cost of £17,111. In 2009-10 the three breast reconstructions carried out at Noble’s Hospital came with a total cost of approximately £13,500.

In that question I did ask them to include travel, accommodation, the pre-op visitations and the 4095 post-op visitations that would be expected. I asked about theatre time for the present locum and the Minister said to me, that it is one day a week and it is a four-hour duration. I do understand from the research that I have done on this, that the simplest breast reconstruction, which is called the implant, which is inflated slowly over time, is a four-hour procedure. So, to my mind, if you have got one theatre session of four hours, that gives you the opportunity, maybe, to do one breast 4100 reconstruction, but it certainly does not stretch to do lumpectomies, removal of cysts, or any other type of breast surgical work that is required.

I followed it up with the Minister, in terms of how we were getting on with the advertisement for the consultant breast cancer surgeon on 22nd March 2011, and he said:

4105

3030


_________________________________________________________________ 1401 T128

‘The Department will, hopefully, be in a position to advertise for a consultant general surgeon with a primary special interest in breast care. This mirrors practice in many hospitals in the UK and we believe, while meeting the needs of our breastcare patients, this is also a cost-effective approach that suits the Island.’

He went on to say that this particular post, this person appointed, would have to partake in the on-4110 call rota for general surgical emergencies, which is one in four.

The meaning of one in four, Hon. Members, Mr President, is one day in four and one weekend in four. So out of an eight-day week, Monday to Monday, two of those days this particular surgeon would be required to cover general surgical on-call commitments. That, of course, is when everybody jumped in alarm. They considered it to have been a U-turn, because in November last 4115 year it was stated a consultant breast surgeon. There was no mention about the general surgery requirement. So this is when things started to get really quite heated and the breast cancer patients became quite agitated, and that is when my work really started in terms of having to look into this in greater depth.

At that sitting of the House of Keys on Tuesday, 2nd March 2011, the Minister kept saying 4120 how he had the support of the breast cancer organisations, the breast cancer charities, and he did say, in answer to one supplementary question, that there was a meeting of the Council of Cancer Charities. They had a presentation by the Department on the way forward and representatives at that meeting, I believe… at least one of the breastcare organisations, and that charity gave its approval of the Department’s stance in the matter, because that was quickly followed up on 1st 4125 April in the Manx Independent by a letter from the President of Breakthrough Breast Cancer Isle of Man, which is headed, ‘We did not approve breast surgery ad’, and of course she went to great length to explain what in fact occurred, and the way she put it – and I will sum it up, because I am not going to read it out – is that they were presented with this situation, and they did not have input into the discussion about whether or not it was, in fact, a good idea. That is the last piece of written 4130 evidence from this particular individual representing Breakthrough Isle of Man.

So what happened after that? Well, Mr President, a group of breast cancer patients came together, past and present. These are women who are currently under the care of the locum consultant breast specialist – others were under the care of the previous general surgeon who had a responsibility for breast surgery – and they came together and they decided that they would put 4135 together a petition on the matter and it would be an all-Island petition. That was commenced with.

All Members, Mr President, including yourself, have had an information pack posted to you, to those who did not attend the presentation last Thursday. So you have a copy of this in your pack. What I can report is there were 7,244 Island people signed that petition. There was an online petition, which gathered 154 signatures, and there was a Facebook site, which got 192 people 4140 supporting it. That in itself was 7,590. Add to that the voice of the Joint Women’s Council, another 6,000, then you are talking about a considerable amount of concern with our people about the continuation of the present level of service that they have come to trust and rely upon.

Then we turn to the job description and the business case. Now, Hon. Members, we received a very last-minute and rushed presentation at lunchtime, provided through the Health Minister with 4145 a senior clinician at the Hospital and our officers from the Hospital, in an attempt to explain what they see as some of the… how shall I describe it as a parliamentarian – inaccuracies, shall we say, in the way in which the group of breast cancer patients have run the campaign and the way in which I have assisted them.

We learned at lunchtime that they had produced a different job description. That begs the 4150 question, does it not, why then, when asked in writing that the Health Minister provide myself and the Hon. Member for North Douglas, Mr Houghton, with the job description and information sheet and the business case in May, now he tells us today there is a different one? Why did he not circulate that information to us? Why did he not advise us? I will suggest why that has not happened and I would suggest this. Once the Department sought permission to place the 4155 advertisement with the Royal College of Surgeons, that the Royal College of Surgeons possibly came back and said, ‘you need to amend this’ and that is probably why there is a different job description now.

Today, Mr President, I have to deal with the information that was provided to me by the Minister and I will. The first thing I would point out, Hon. Members, is that on page 2 of the first 4160 job description and information sheet, it talked about duties of the post and it said the post will have up to 10 programmed activities, which will broadly comprise the following: seven and a half PA. What is a PA? A PA is equivalent to three and a half hours. So you calculate 7½ x 3½ hours would be direct clinical care. Clinical care of inpatients and outpatients, including provision of one in four non-resident, on-call, cover for general surgery and urology. We are told at lunchtime 4165 today urology is being dropped!

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I am pleased about that and I would hope that that has probably been as a consequence of some of the scrutiny that the campaign and the Royal College of Surgeons have been giving to the matter. But the urology was included. It was repeated again on page 3:

4170 ‘The newly appointed consultant will partake in a one-in-four non-resident on-call for general surgery and urology with the other three consultants.’

We now know that has gone. It then went on to the person specification, the professional qualifications that would be 4175

needed: full registration with the General Medical Council and on the General Medical Council specialist register or eligible for entry within six months of interview. That is quite common. In a lot of these jobs that are advertised by the British Medical Journal and on the NHS online sites, they ask to be included on the special register within six months of actual interview, so that is not uncommon, but I think the point to be made here is that our current locum consultant breast 4180 specialist has been on the specialist register, operating on breast only and nothing else, since 2008. So, since 2008 she has purely just been doing breast work and nothing else. That can be checked by Hon. Members on the General Medical Council register.

The suggested job plan at that time said that there would be two theatres, one of three and a half hours and one of four and a half hours, and just three clinics. Currently, we have four clinics. 4185 We only have one theatre, but we have four clinics. So the first thing I did when I got a copy of this was I made an appointment to go and see the formal general surgeon who had a responsibility for breast surgery and I visited him at his home. He was as concerned as I was, and he said there is a shortage of clinics, and there is also a dilution of the elective general surgery in dealing with emergencies. His concern was he had empathy for the three general surgeons having to operate a 4190 one-in-three, but he said it should not impinge on the breast care service, and he did not believe that the breast care service should have to take on-call general surgery. He said there was a risk that if this person was practising breast surgery most of the time and then, occasionally, on the on-call, had to rush in to do an emergency operation and it was a tricky bowel operation or something of that nature, that general patient might be put at risk, because of the non-elective practice of 4195 general surgery. So that was the starting point. He advised me to make contact with the Royal College of Surgeons, to try and find out who the person would be who would be appointed to receive the Isle of Man’s application, so I thank Mr Clague, because he helped me very much from the start and he pointed me in the right direction.

So to the Royal College of Surgeons I went and, eventually, after a number of e-mails, I was 4200 put in touch with a consultant general surgeon, a Mr Zeiderman, who is Director for Professional Affairs for the North West. I e-mailed him – all Members have this, and they can see my e-mail to him – where I had a concern that, because of the escalating number of breast cancers, which up to 31st March were somewhere around 90, that there would be a risk of that service being cut, and also the dilution of the elective general surgery, in dealing with general emergencies. 4205

He responded to me and he said, and I quote: ‘Thank you for your recent e-mail and for explaining the situation around the proposed appointment of a new consultant surgeon with an interest in breast disease. Unfortunately, what you have asked me to address is outside the remit of the College in the appointment of a consultant, to ensure that the conditions of the post will enable the 4210 appointee to deliver a safe and effective service to patients. The College adviser will need to consider the professional content of the post, ensuring that…’

so that there is a balance of activities in terms of theatre, teaching, managerial work, research work and, of course, study, which is an essential part of any consultant surgeon who is appointed. 4215 Unfortunately, he goes on to say, ‘the need for the post and the way in which it will fit into the service is determined by the Trust’ – in this case Noble’s – ‘and the College has no input into this process.’ But then he tries to be helpful and he says, ‘in my experience, a general surgical appointment with a special interest would usually involve a 50% commitment to each.’ That made me even more concerned because, currently, we have 100% service and this gentleman was 4220 suggesting that it would be 50-50.

I then had heard of the… well, in fact the Holcombe Report is referred to in the Isle of Man’s Department of Health business case. They refer to a Holcombe Report. This was a review of breast services in the Isle of Man, dated November 2007. Christopher Holcombe is the consultant breast surgeon, clinical director of breast services and lead cancer clinician, Royal Liverpool and Broad 4225 Green University Hospitals NHS Trust. I made contact with him and asked him and said I was very interested in him securing, or seeking, to secure a good breastcare service here in the Isle of

3232


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Man. I understood that he had done this review and this study and it would be interesting to have sight of his Report.

I actually received it the next day. I was quite shocked, because I thought I might struggle in 4230 getting a copy. I had been told by other members of the Department, if it was an internal report, I could not see it. Christopher Holcombe sent it and it was not under private and confidential cover or restricted cover, so I thought it was befitting to actually furnish all Hon. Members with it.

He starts off by saying it is unlikely that a replacement similar to Mr Clegg, who can do breast, general and vascular surgery, will be found. 4235

A newly appointed modern breast consultant is unlikely to be on the general surgical on-call rota. It is a very important point to remember, Hon. Members.

There were a number of things that were of interest in here and should be of interest to Hon. Members. He made 10 recommendations. There was only one where he recommended that Liverpool continue to be engaged. That was his view at the time, that breast reconstruction should 4240 be carried out in Liverpool by the team who visit the Isle of Man, but all the other services, he felt, should take place in Noble’s Hospital on the Island. He described our service at that time as fractured. He said it was fractured. He also went on and he looked at the programmed activities. He looked on the recommendations that he was basing some of his findings on, and he says, and I quote: 4245

‘The provision of breast services on the Isle of Man has not kept step with modern developments in this field. In particular, there is no MDT, no on-call plastic breast surgery provision, no sentinel node biopsy, limited access to breast reconstruction and no screening service, although this is planned.’ 4250

He says: ‘As breast surgery becomes increasingly specialised, complex and multi-disciplinary, the provision of this service by the generalist with an interest becomes increasingly difficult. These recommendations seek to enable long-term recruitment and retention.’ 4255 You will find, Hon. Members, that if you actually read through the business case, which the

Minister did not give you an updated copy of at lunchtime, but you will have one which was obtained by myself and the Hon. Member for North Douglas, Mr Houghton, in May, which was in your information pack… he makes some very valuable comments in here and he is trying to be 4260 helpful, in terms of how he sees us going forward. It is interesting that, in 2007, he was referring to the Isle of Man having 60,000 population – 2007 was not that long ago, four years ago, 60,000 population. We are estimated at around 82,000, although I hear figures of around 85,000. I gather we will not know for sure until the end of September when, hopefully, the results of the census will be made public. 4265

He also says that the service receives around 700 symptomatic referrals per year, which results in around 53 diagnosed cancers per year. That was back in 2007. We have gone from 53 up to 93 this last year. That is quite an increase. The referrals per year, I have taken again from the business case amount, on an annual basis, according to that as 1,248. The Minister, in his information pack today, is quibbling with my figures and saying I have got them wrong. Well, I have only taken 4270 them from your business case, Minister.

He goes on about maintenance and skills and he makes the point that the modern breast surgeon now, during the last 12 months of their training, focuses just purely on breast surgery, because it is becoming so complex and they do not do any general, surgical work and they certainly do not partake in on-call general surgery. What he says in here is very interesting on that 4275 aspect of things. He says:

‘the biggest factor in recruiting and retaining high-quality staff will probably be the interest of the specialist work in which they are to be involved. There has been increasing specialisation within surgery, well illustrated by the English national oncoplastic training programmes, where senior breast surgical trainees spend a year without any general 4280 surgery or on-call commitments, learning the techniques of breast reconstruction and plastic surgery. This has been highly successful in producing a cohort of highly trained, specialist breast surgeons, capable of managing the whole spectrum of breast disease and able to provide a wide range of reconstructive plastic surgery procedures.’ 4285

He then goes on to say: ‘However, this has often been at the cost of general surgery and many of these trainees, when they are appointed as consultants, are not undertaking significant volumes of general surgery and are not on the on-call general surgery list. This is due to the demands of a high-volume breast practice, a rapid loss of skills in general surgery, due to the lack of 4290 use and training in general surgery that today has much less breadth and depth than in previous years.’

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He suggests that it will be a difficulty for us. Needless to say, at the very end of his Report he says:

‘Overall, it is striking how particularly the surgical service has not kept up with modern developments in breast 4295 surgery.’ That was November 2002. I took up correspondence with Mr Christopher Holcombe, Mr

President, and I basically asked him, as it was a very interesting Report, but bearing in mind it was 2007 – the population is larger, the cases of breast cancer exceeding 90 for the first time – 4300 ‘whether your recommendations would still be the same for the future operation of breastcare services here. I look forward to your response and am sincerely grateful for your assistance.’

He came back to me and he said most of the principles are the same. He said the big challenge you face, as I see it, is that cancer care, including breast cancer, is becoming increasingly specialised and technical. He then goes on to say: 4305

‘It would be reasonable for you on the Isle of Man to recruit a whole-time breast surgeon, as even the more routine work is now much more specialised and would warrant this: example, screen detector cancer, sentinel node biopsy and oncoplastic wide local excision.’ 4310 So he was basically saying to me, fairly the same but, in fact, you need a whole-time breast

surgeon. I went back to him more recently and asked him about the dispute the Minister and I had in writing, I believe of which all Members were copied, in terms of a set of recommendations, or regulations, 1996, which describe the training of a general surgeon with an interest in breast vis-a-vis the oncoplastic guidelines dated 2007. Just to be absolutely sure, he said the oncoplastic 4315 guidelines are more about the guidance for that sort of surgery. Further, the consultant said to me there was no correlation between the two.

So the task has not been easy, Mr President, because I have endeavoured, through all of this, to try and meet with the Minister, together with my colleague, Mr Houghton, so that we could get round the table and discuss what it is that we had concerns about – and it was only in the last 4320 fortnight the Minister offers to meet with his clinicians. Chris Holcombe said, when I asked him about the one-in-four rota, he said it could be one night in every four, could be one day and night in four, could be one week in four and this could be with cancellation of routine activity, when on call or continuation of these. But it would generally be that that person doing that rota will be on call 25% of the time. So we have had 50%, we have had 25%, but we still know there is a 4325 percentage that is taken away.

The final piece of evidence – and you will be pleased, Mr President, that I will wind up after this and let the debate flow. I made contact with the President of the Association of Breast Surgery, Mr Richard Rainsbury, who is an eminent surgeon, a figure who is regarded as a great authority in the world on breast surgery and he was very helpful. I sent him a long and detailed e-4330 mail, and all the facts and figures that I pulled out of the Isle of Man Department of Health’s business case and Hansard in terms of the figures of breast diagnosis and sent that off to him and asked his opinion.

I was aware that, under the normal standards, one has to have quite a large population to be able to warrant a breast surgeon, or a breast specialist. Indeed, with our small population we did 4335 not satisfy that criterion, nevertheless, my research uncovered that, in fact, to have one breast specialist in post now dealing with the amount of work that was coming through, the patient load was high enough to justify a dedicated breast surgeon just for the task. He went on, he was very helpful and pointed me in his e-mail, which Members have, he pointed me out to the special provision that is made out in the European Journal of Surgical Oncology, dated 2005. Section 4 of 4340 that covers small jurisdictions, such as islands, and the criterion there is that each surgeon must deal with at least 10 breast-cancer cases a year, or up to 30 a year; one surgeon. Our surgeon here has been dealing with a much higher rate on her own.

He went on to say, he congratulated the Island and I was very proud, when I received this e-mail, to get such praise from such a high-ranking individual in the world of breast surgery. He 4345 said:

‘Firstly, can I congratulate the breast unit and the locum consultant breast surgeon on the key steps which have already been taken to implement a high-quality breast service for Islanders. 4350 These laudable developments include screening, specialist clinic, specialist nurses, MDT

meetings and the potential for providing a comprehensive sentinel node biopsy and breast reconstruction service in the future. You have been fortunate in securing a specialist surgeon with

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the necessary leadership to make these changes, often difficult in a small Island. Moreover, the MDT includes a visiting oncologist, giving the externality which is so important in preventing 4355 isolation and ensuring best practice. It is clear from the activity figures provided that the breast service meets and, indeed, exceeds the requirements of a modern breast unit established by the ABS guidelines…’

And then he goes on to point us to the European Journal of Surgical Oncology. He says that the recommended minimum case-load in that document is 30 per year, per surgeon. In the United 4360 Kingdom, the average is around 50 to 100 new breast cancer patients, per surgeon, per year.

He suggests that with the figures we have, a strong argument could be made for additional specialist input, perhaps in the form of a breast physician. This recommendation is also supported by the high new patient referral rate – 25 new patients being referred a week. Again, this is taken from the Department’s business case, which is a very big workload for a single surgeon. 4365

Then he goes on to say: ‘A single four-hour theatre list is not nearly long enough to even carry out the very basic breast cancer surgery.’ The ABS guidelines recommend at least two per week and if we were going to roll out sentinel 4370

node biopsy and breast reconstruction, then we would need additional theatre times, another two a week.

He went on to say: ‘Breast surgery is becoming increasingly sophisticated and the overwhelming majority of breast units in the UK are 4375 now appointing pure breast specialists in order to keep up with the rapid pace of new developments and the escalating workload.’ He went on, of course, to say that the appointment of a general surgeon with urology interests

would be a very retrograde step. I wish to place on the record that the Department has now 4380 withdrawn the urology aspect from their… The Minister is shaking his head, but I go by the written word, Minister, of what you have provided to me and my colleague. The urology was part of it. I have read it out to Members. It is now not featured, and so that has been accepted by Mr Rainsbury, but he went on to say it would be detrimental to service development and, most important, detrimental to patient care. 4385

The other point that he makes… and if Members go back to the presentation – the very rushed one we had at lunchtime – we were told in no uncertain terms, and it is reaffirmed in some of the information the Minister has given us today in his information pack, that they expect the incidences of breast cancer to start coming down. Indeed, they believe that it has peaked in the Isle of Man. Bearing in mind we have only had a breast screening recall service start at the beginning 4390 of 2008 – February 2008, I believe it was, so we are just over three years – the Department is under the belief, just dealing with the breast screening and recall, that once we have recalled all the patients that we have already screened we will become familiar with those patients, so that when they come for subsequent screening, if there was something that perhaps looked a little mysterious it might be passed aside because, ‘Oh, yes, that lady had it last time and the time before – it’s not 4395 anything significant or anything we should be concerned about,’ and as a consequence the numbers will come down. In fact, that is not the case, because the President of the Association of Breast Surgery says:

‘Addressing your final point about whether breast cancer rates are levelling off, there is clear evidence that this is not 4400 the case.’ Not the case! It is predicted to continue to rise between 2005 and 2024, representing an

increase from 41,900 to 55,700 new cases per year in the United Kingdom over that period and not forgetting, Hon. Members, that when we had the first debate in 1996, the Hon. Member for Garff 4405 quoted the figure of 20 odd thousand, 25, I believe he said in Hansard. That has grown to 41,900 and predicted to rise to 55,700. So it has not peaked in the United Kingdom, where they have breast screening and recall. So, if it has not peaked in the United Kingdom, what evidence do we have that it has, in fact, or is about to peak here in the Isle of Man? In fact, he goes on to say that the World Health Authority predicts a global epidemic of cancer, including breast cancer, with 4410 cancer becoming the leading global cause of death, ahead of heart disease, by 2030. Those are the predictions. He said,

‘I am glad to have provided the information. I hope this strengthens your case for the appointment of a specialist breast surgeon to a permanent position.’ 4415

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I can say, Hon. Members, Mr President, that I received the correspondence between Mr Upsdell at Noble’s Hospital and Mr Rainsbury that took place on Sunday, I have received a copy of Mr Rainsbury’s response. He has asked that I be circulated with it, but he has not necessarily given permission for it to be circulated to Members, but what I can say to you is that he has not changed his opinion. His opinion has not changed. He acknowledges that the job description does 4420 now not include urology. That was acknowledged and that part of the letter was read out to all Hon. Members during the lunchtime presentation, but his view is still one and the same.

So, he has not withdrawn his view or changed his opinion in any way, shape or form. Mr President, I have letters, I have an opinion from Prof. Blamey, who was also… he retired a

year ago, but he was the President of the Association of Breast Surgery and quite a large file of 4425 letters from individuals Island wide.

What I am asking Hon. Members to do, is to really consider this very seriously today, to forget who the mover of the motion is, to forget it is me who is the messenger, to try and cast aside your feelings about me as an individual and as a personality, because we have had conflicts in the past and we have had variants of opinion and we have clashed on many issues, but then together we 4430 have pulled together on other issues. I am asking Hon. Members to cast aside all of those feelings that you have about me as an individual. All I am is the facilitator for the people in the Isle of Man who suffer with breast cancer. That is all. I acknowledge there are other types of cancer and that we should be doing as much as we possibly can, but we have for breast cancer.

We have had a wonderful service. We still have a wonderful service. The people do not want 4435 to see that service diluted in any shape or form, (A Member: Hear, hear.) whether it is 50%, whether it is 80%, whether it is 75%, whether it is 70% and there are lots of percentages that have been featured today at our presentation at lunchtime, about the reduction in the breastcare side of things. But whatever percentage it is, Hon. Members, it is a reduction in what we have now. I am merely asking the Court to approve my motion, as written, that we go for the appointment of a 4440 dedicated consultant breast surgeon and not a general surgeon with an interest in breast. The main, salient point here, Mr President, is that the Department want the new person coming in to partake in general surgery on cover, one 24-hour period every fourth day.

I think that is too much. If we need some general surgery input, then we should be looking at that and we should be looking at that separately. I do not feel that we should be poaching the 4445 breastcare service that we currently enjoy.

I beg to move. The President: Mr Houghton, Hon. Member for Douglas North. 4450 Mr Houghton: I beg to second, sir, and reserve my remarks. The President: Mr Anderson. Mr Anderson: Thank you, Mr President. 4455 I would like to, like the mover of the motion, put on record that you do not actually judge what

I am saying on the person, but on the information that person is bringing on behalf of the Department and behalf of the professionals of the Isle of Man.

I, like Mrs Cannell, am a lay person. I am not a professional. I take advice from professionals. The business case for this post has been worked up by commissions and professionals, so what I 4460 am saying is ignore the messenger and just listen to the message.

Mr President, I believe that the motion that the Hon. Member for East Douglas has put down is a flawed one, and that is:

‘That Tynwald is of the opinion that a dedicated consultant breast care surgeon should be appointed rather than a 4465 general surgeon with an interest in breast.’ Mr President, the Department’s proposal is exactly as the Hon. Member’s motion begins: that a

dedicated consultant breast care surgeon should be appointed. This is evidenced and outlined in the job description and job plan approved by the Royal College of Surgeons and in the 4470 Department’s three-phase plan for the development of Island breast care services. Both of these documents have been made available to Hon. Members.

Based on the job description and person specification within it, when the post is appointed, the Department will have a dedicated consultant breast care surgeon, but they must hold the formal job title of ‘a consultant surgeon with a special interest in breast care’, as directed by the Royal 4475

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College of Surgeons. Its governance remit covers the approval of all surgical job descriptions and job plans.

Two elements of this motion are therefore co-requisites. To vote for a motion that proposes the Department of Health should not appoint a general surgeon with an interest in breast, is to actually vote against the Isle of Man having a dedicated consultant breast care surgeon. The Hon. 4480 Member’s motion, therefore, is contradictory, paradoxical and therefore flawed.

A motion to accurately reflect the intention of the Department of Health, Mr President, is one that I am going to move as an amendment and I would like that to be circulated now, if it has not already been done, sir.

I am moving an amendment that is framed to accurately reflect the intention of the Department 4485 to improve the very good service that the Department currently provides with breast care services, and I am grateful for that being circulated at this moment.

Services will be enhanced, not downgraded. This is a progressive step and not a retrograde step. Mr President, this debate must be based on facts, and the facts show the Department’s proposal to be sound – a proposal that was made by senior clinicians, doctors and nurses who 4490 understand the business of health and understand the needs of patients, a proposal which has received strong support from breastcare charities, members of the public, clinicians independent of Noble’s Hospital and also those in the Department. I would again reiterate to Hon. Members, despite the nuances of the job title, which may have caused some confusion, that the breastcare service available on the Island will not only be as good as it is now under the current locum – who, 4495 I would remind Hon. Members, is both eligible and welcome to apply for the post and whom we cannot appoint, of course, without openly advertising the job – but the post will be enhanced as follows. Phase 1 of the Department’s three-phase plan… and Mrs Cannell is right, at one stage this was a three-year plan. It is now a three-phase plan, because we believe once we have got the consultant in place we can actually move it forward faster than the three years. The first phase is to 4500 appoint a dedicated breastcare surgeon to the post; phase 2 is then to introduce a sentinel node biopsy service; and phase 3 is to offer on-Island breast reconstruction. I would reiterate, Hon. Members, it is a positive that this is a three-phase and not a three-year plan, and we hope, upon appointment, to be able to promptly develop these services, ideally in well under these three years.

Additional outpatient clinics and additional theatre sessions per week will be available to the 4505 postholder, which will increase our capacity to accommodate the service enhancements that I have mentioned. The postholder will, therefore, be a highly skilled breast surgeon and a dedicated breast surgeon with specialist registration who will lead the service on the Island and develop it further, enhancing the level of care available. This is exactly the same type of job the locum consultant was doing before taking up her locum post here on the Island. The current breast 4510 surgery workload is quite sustainable within our current resources and, indeed, as I have just said, such is the current capacity, we will be able to enhance our service, accommodating this extra workload without the need for a second breast surgeon. Although there has been an increase in the number of detected breast cancers, as was to be expected following introduction of our call and recall service, this has now peaked and numbers have returned to their pre introduction of call and 4515 recall state. The indications are there will be 55 to 60 breast cancers detected per year, as there were before the breast call and recall came in, and I just put on record the figure that Mrs Cannell was quoting was that high peak, those 93 cases that we had in a 12-month period.

Although it is true breast cancer is increasing across the developed world, the increase will be gradual over the next two decades and any increases over the next few years can be well 4520 accommodated within the proposed postholder’s workload. The number of breast cancers diagnosed between 1st January and 15th June this year stands at 26 detected breast cancers. Extrapolated, this would put us on a course of between 55 and 60 cancers this year, or approximately 1.15 people diagnosed each week. This is much lower than in 2010, which I have said we expected to be high due to the introduction of our call and recall breast screening service. 4525

I should point out this rise was always anticipated by professionals and has not been a surprise. Subsequently, these figures mean that an average of less than two patients a week require breast surgery. The present locum undertakes two to three operations per week. I can confirm to Hon. Members that only two breast operations per week were undertaken at Noble’s Hospital between 1st January and 13th March this year. This compares to a peak of 42 surgical procedures in a week 4530 for one consultant surgeon with a special interest in upper gastro and colorectal surgery.

I now move to the responsibilities on all parties to communicate clearly, truthfully and factually on the petition.

Mr President, the Department has – and I will deal with the petition a little later – the Department has worked hard to communicate clearly the intentions of this post and the benefits it 4535 will bring. Unfortunately, that communication work has been continually frustrated by misleading

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and irresponsible comments from certain quarters. Mr President, the petition, in particular, has caused concern and fear for those who have gone through the trauma of breast cancer to be told, in future, the first-class service provided to them was going to be downgraded. That, of course, is not the case. In fact, that is what we should be concentrating on; the person who will fill the 4540 permanent post will be as qualified at the same level as the present, temporary, locum postholder. Without looking in depth, most people would sign a petition opposing a downgrade of a service, but the vast majority do not appreciate the service is not being downgraded, but enhanced, and I am very pleased for those who have said they signed the petition, but now understand what the Department is doing to improve the service, who would not have signed if they knew the facts 4545 before and that had been explained to them. I had a relative in that category, who only signed because she was asked to do so as a former breast cancer patient.

Mr President, I have spent three and a half hours going through the names, making careful notes, so that I can explain to my constituents the facts and not the slanted view that has been put on it by the Hon. Member and the breast cancer action group. I will not do what a former Tynwald 4550 Member, Mr Victor Kneale, once did, and spend a huge amount of time in breaking down and ridiculing a public petition. I neither have the Court’s time or the appetite for such an exercise. However, I would comment, to give advice to those who might seek to conduct such an exercise in the future.

Firstly, that signatures without printed names lose credibility and vice versa. The online names 4555 also had no addresses, although I knew who Brenda Cannell was.

Secondly, there are many addresses from off Island, and probably from shop counters… and shows people are very obliging and, if asked to sign, will do and will oblige, even if they are not directly or indirectly impacted.

The third point I would make, that a comments column online is useful, as it sometimes shows 4560 their level of understanding or not, as the case may be. Many more, including those at the Joint Women’s Council last week came up and thanked our team for clearly explaining; ‘If I had known that before this evening, I would not have signed.’

Hon. Members, we have a responsibility, as Tynwald Members, to relay such information to the public and to reassure the public, rather than fostering a climate of fear. I am grateful to 4565 Tynwald Members who have availed themselves of that opportunity. We have provided the evidence for the proposed improvements, and I am also grateful for the continuing support, despite being publicly criticised by the action group, of both Breakthrough Breast Cancer and Breastcare Support Group. They had questions about the proposed service at the beginning. After all, they know more about trauma than most of us and are engaged helping those affected. 4570

They would not support a downgrading of service. They listened and they heard – recognised it will be an improvement.

The umbrella organisation of the Council of Cancer Charities fully endorsed the Department’s proposal and they have agreed to supply a member for the interview panel as a layperson to make sure they have a voice in that policy. 4575

Mr President, I now move on to clarify the requirements of being on call. Mr President, I think it is also vital we are clear on the ‘on call’ element of this role and what it actually entails.

As I have emphasised many times over recent weeks, this is a minor element of the role and will not impact on the volume of breast cancer cases we can deal with and it will not cause any increased waiting times. Quite simply, there are no negatives and many positives. We maintain our 4580 service. We will enhance our service over the coming months and years and we will also be able to meet the Royal College of Surgeons’ direction that we increase on-call general surgical cover from one in three, considered by the College to be onerous – too onerous – to one in four. The one in four is a period, and this I think is very important to emphasise because I think it came out quite wrong a little earlier – the one in four is a period of 24 hours in every four days and one weekend 4585 from 1700 on a Friday evening until nine o’clock on a Monday morning in every four weekends.

Emergency admissions, as we know, average about 4.5 emergency general surgical missions in any 24-hour period. Of course, many of these will not require an operation and when admissions come in under the new consultant surgeon, it is likely that the ongoing care will be provided by one of the other consultants, ensuring that general surgery does not take precedence over breast 4590 work.

This practice is completely in line with hospitals of a similar size to that of Noble’s, as Hon. Members will have seen from the job descriptions distributed to them and provided for them.

Out-of-working-hours cover, it should be noted, sees the consultant at home resting but on call. The consultant is not routinely in a clinical environment outside of normal working hours unless a 4595 very serious emergency arises. The on-call workload is, in the main, carried out by the consultant’s medical teams with the consultant working to oversee and advise.

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I would just like to mention adherence to the guidelines and requirements, Mr President. I would like to remind Hon. Members that we are meeting the requirements laid down by the Royal College of Surgeons and the professional body for medical practitioners. It is not simply about the 4600 views and involvement of laypeople, although this is critical and welcome; the key is to gain the support of the professional clinicians in the area and, of course, the Royal College. It would not endorse the job description and job plan unless they were clinically based and sound – that is what we have waited for to this point before progressing.

There have been substantial tweakings to get the post defined to their high standards and gain 4605 the Royal College’s approval. The surgical guidelines for the management of breast cancer, as published by the Association of Breast Surgery at the British Association of Surgical Oncology 2009, stated explicitly that breast cancer surgery should only be performed by surgeons with a specialist interest in breast disease. I am sure it will not escape Hon. Members that this is why we have described the job in line with the Association’s guidelines. I would also note that the current 4610 locum has the lowest number of patients requiring procedures of any of our surgeons and is the only surgeon not participating on the on-call rota.

In similar jobs across the UK in similar hospital services, the surgeon would expect to take part in a general surgical on-call emergency rota – it is what the doctors expect to do.

The Hon. Member has asked opinions from those off-Island with out-of-date data and an out-4615 of-date business case. She has had the first draft of the business case and that has been refined as it has gone back and forth to the Royal College for refinement several times. The off-Island experts are not, therefore, basing their comments on this information. If they did, you would get a different comment or view. If you want a question answered in a particular way, you ask it in a particular way. We brought the same question to the same people with the accurate data and they have given 4620 us a different and more accurate answer with the full knowledge of the facts.

Now I come to the breadth and depth of support. Mr President, Hon. Members will be aware of the body of support the Department’s plans have received from a wide and varied range of organisations and clinical professions, including the Isle of Man Council of Cancer Charities, Isle of Man Breast Care, Breakthrough Breast Cancer Isle of Man, the Royal College of Surgeons, 4625 retired Professor Howard Scarffe, Dr Malcolm Clague, Mr Roy Clague, and, lastly, we have had a letter of support from Mr Peter Evans. Unfortunately, that letter he hoped would have been published in the paper and it has not been, but I think it gives a very good insight and I will refer to that now, Mr President:

4630 ‘I was the radiologist with responsibility for breast radiology (my job title was “general radiologist with an interest in breast disease’’) until my early retirement at the end of 2010. I have recently seen the letter from Julie Stokes about the replacement breast surgeon. It would appear that the topic is generating opinion which is becoming very (almost too) public. I should be grateful for the opportunity to add my own comments. The local cancer charities pushed hard in my early years as radiologist here for the provision of call/recall breast 4635 screening. Since its introduction, this up-rated service has resulted in high breast cancer pick-up rates on the Island over the last two years. Indeed, figures for the first year of screening showed a pick-up rate of breast cancer, which was the best of any region of the UK by a significant amount. This is down to the quality of pictures provided by the radiographic staff at Westmoreland Road and the film readers in Coventry, who decide which ladies need to be recalled for further tests 4640 and treatment. It is recognised that the first full round of screening boosts the numbers of breast cancers detected, which then return towards the underlying (pre-screening) rate. Therefore, the figures over the last two years cannot be used as the basis for the amount of recurring work from breast cancer which can be expected in future. The underlying rate for the incidence of breast cancer on the Island is approximately 55 new patients a year. I am told that the figures for the first 4645 half of 2011 confirm this impression.’

And, Mr President, I quoted those figures earlier on. ‘Mastectomy is required in the minority of breast cancer patients and there are many ways of achieving reconstruction 4650 for those who need it. Setting up such a service here would require discussion by hospital administration with theatre staff, anaesthetists and, ultimately, the newly appointed breast surgeon; in management jargon a ‘business plan’ is required. It would be most unusual to invite any locum consultant to introduce a new service. When a permanent breast surgeon is appointed, I would expect the Hospital to discuss with that person what level of breast reconstruction is appropriate here and which patients would be better referred to a plastic surgery centre (oncoplastic breast surgery). 4655 Whether the Hospital needs a surgeon who does only breast surgery or breast and general surgery will clearly revolve around the workload. The previous surgeon and his team dealt with this surgical workload in approximately two days per week. If there is to be expansion of the service to provide – for instance – breast reconstruction on Island, then this would require more time. To appoint a consultant surgeon to look after 55 new breast cancer patients each year, plus the follow-up of patients 4660 who have completed their treatment (and patients with benign breast disease) would not (in my opinion) provide enough work for a full time post. The alternatives are therefore to make the job part time (usually an unpopular and unattractive option) or give that person other surgical work to make the job full time. Adding extra responsibility to the

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breast surgeon post does not imply that a reduced level of skill in breast surgery (or the associated general surgery) is required. 4665 Any surgeon appointed here to a post ‘’with an interest in breast disease’’ would automatically have experience in general surgery which would have been acquired prior to breast specialisation. The current breast surgery locum will undoubtedly have experience in the type of general surgery required for the proposed job. I believe I am right in saying that any medical consultant post which is appointed on a permanent basis must be advertised and interviews held. In the interest of fairness, an existing locum cannot simply be made permanent, 4670 however capable the locum and however desirable it might seem. From what I have seen and heard, everyone involved wants the best appointee for the post of Breast Surgeon. I wish the hospital well in its search for a permanent replacement for Mr Malcolm Clague and hope that everyone is happy with the person who is eventually chosen to succeed him. May I take the opportunity of thanking the staff at Noble’s and particularly the radiology staff and the breast radiology 4675 team, who made working at Noble’s such a pleasure over the last twelve years. Yours etc Dr Peter Evans’ [MB, FRCS, FRCR 4680 Consultant General Radiologist with Special Interest in Breast Disease, Gibraltar] Mr President, all experts who understand the needs of a patient and services here on the

Island… You have heard that the Member for East Douglas has the support of off-Island experts. We know they have answered her questions, framed in such a way to elicit answers in her favour. 4685 We know their true position in this debate. Mrs Cannell does not have the support of any medical practitioners on the Island, either in or without the Department of Health.

Understanding, Mr President, of general surgery… General surgery has a somewhat unfortunate name, one perhaps not befitting the varied and critical surgical work undertaken in this specialist field. Of course, any of us would be forgiven for shirking at the thought that any surgical 4690 procedure we were to undergo could, in any way, be ‘general’. All surgery is an unsettling experience. The term perhaps does not engender the same images of neuro or plastic surgery, but let us be quite clear: despite its name, general surgery is a specialty and one of only nine. To be more accurate, general surgery relates to surgery of the torso. The other eight specialties are cardiothoracic; neuro; oral and maxillofacial; ear, nose and throat; paediatric; reconstructive; 4695 trauma and orthopaedic; and urinary. Hon. Members may note that I have not mentioned breast surgery because this, in fact, is a sub-specialty of the specialty of general surgery, amongst other sub-specialties which include colorectal, endocrine, upper gastrointestinal – that is the liver and stomach, transplant and vascular. Therefore, Hon. Members should be in no doubt the only way to become a breast surgeon is to specialise in general surgery. It is therefore wholly appropriate to 4700 have the proposed post advertised as a consultant surgeon with a specialism in breast care.

It is this special interest that recognised the role requires a general surgeon who is specialised in breast surgery – that is to say, someone who is a dedicated breast specialist surgeon. Indeed, the UK experts who provided Mrs Cannell with their opinions are general surgeons.

Mr President, when all is said and done, I absolutely understand the desire of everyone to have 4705 a first-class breast care service in the Isle of Man – a desire we share. Remember, our clinical team only have the patients’ best interests at heart. People have become rightly concerned about the issue, due to misleading information, and I have worked hard to set the record straight with the public interest organisations and Hon. Members through such presentations that we laid on today – and it was not a ‘rushed presentation’. It was a presentation that was put on following some 4710 information that went out last week that I felt we needed to clarify before this debate.

My clinical colleagues are extremely concerned by the information put in the public arena. At best, they view it as irresponsible, at worst, dangerous. The protection and enhancement of our breast care services is exactly what I would want to see and what the Department proposes, and I truly believe that the proposal the Department has made is the best and only way forward. 4715

In effect, Mr President and Hon. Members, there are not two sides to this debate, only one. The Department, including its clinical experts, the Council of Cancer Charities, Breakthrough Breast Cancer, Isle of Man Breast Care, the Breast Action Group and Mrs Cannell all want the same thing: a dedicated breast surgeon and enhancements to our breast care service. That is what it is proposed. That is what the job description describes. That is what the Royal College of Surgeons 4720 approved.

We are now, I believe, quibbling over semantics and the nuances of her job title. As I have said time and time again – I want to reiterate it now – the postholder will be trained to the same level and will be equally as competent as the current locum surgeon, but we want a permanent surgeon to lead this service. 4725

Mr President, I would therefore implore Hon. Members to vote in favour of the amendment in my name. To vote against my amendment delays the development of the Island’s breastcare

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service, for which the Department has worked long and hard to bring to fruition for the benefit of the people of the Isle of Man. My motion should be supported, as Mrs Cannell’s motion brings no benefits to patients and their families. 4730

I would just like to touch on one or two things the Hon. Member made in her contribution that I had not prepared for.

Mrs Cannell referred to the Holcombe Report: that was dated 2007 and she is correct, it was an internal document, commissioned for the Department from Prof. Holcombe. That Report was within the Department and it was not for public release. Prof. Holcombe has released it and he is 4735 rather embarrassed now that he has. He did not realise it was going outside of the Department. However, we have to recognise the Holcombe Report was a snapshot of the services four years ago. Prof. Holcombe said that it was a fractured service. It was a fractured service at that time and I would like to put on record my thanks to the team that have improved the service and have planned what is actually happening now. We have put in breast call and recall. We have put a 4740 locum into the post, we developed the business case.

Once we get a permanent postholder in, we will be developing the service even further, so that is a historical document. Of course, we did not go on all Prof. Holcombe’s recommendations, because one of those key recommendations is that we should have a visiting surgeon visiting the Island and we did not think that was appropriate for the ladies of the Isle of Man. We recognise 4745 that we should have somebody on-Island and the majority of their time would be spent as a specialist breast surgeon.

In relation to the reference the Hon. Member made to me refusing to meet her, there were two occasions the Hon. Member refused to meet me and I have invited her twice to come in to get a better understanding of our business case, because I knew she was confused about the business 4750 case. She has refused to do so, because, she says she had got the motion coming to Tynwald now, anyway, but that opportunity was given on two occasions. So I refused to meet her on one occasion because, by that time, she had called a public meeting and I said I would give her that information at the public meeting. However, I was more than happy, my door has always been open, my clinicians would have been very happy, for her to come and have it explained and 4755 corrected in certain areas. It is unfortunate that she has taken the stance she has, because it has unsettled members of the general public.

Mr President, I hope Hon. Members will support the amendment in my name, which reads: Delete all the words after ‘Tynwald’ and add, ‘supports the Department of Health ensuring 4760 that the Breast Care Service is maintained and enhanced to ensure that there is no diminution in the present level of service provided within the Island, and supports the Department continuing to provide a dedicated breast care service led by a surgeon specialising in breast surgery, thereby securing the service provided to patients.’’ 4765 The President: Hon. Member for Ramsey, Mr Bell. Mr Bell: I beg to second and reserve my remarks. The President: Lord Bishop. 4770 The Lord Bishop: Mr President, I have had the unfortunate privilege of being closely related

to someone who had very serious surgery for breast cancer a decade ago. There will be people in the public gallery who know, as well as I do, that it is a frightening experience for the patient and for the patient’s family. I also have a close family member involved in cancer research. I have, 4775 therefore, looked and listened into this issue over the last decade with very great care and, as a result, cannot support this motion and want to support the amendment.

Even in centres with far greater population bases than ours, there are normally general surgeons with breast specialisms. We all know, and we have been reminded, about the recent catch-up spike in this statistical graph of cases on the Island. This is not what it seems. What we 4780 might consider to be real is the scenario offered to us earlier in the debate about the risks to a patient of a general surgeon with breast specialism, called on to perform bowel surgery. When I was in my late teens, I had to have two very serious operations, performed in one case as an emergency by a general surgeon. If I had been offered the choice of being operated on by a general surgeon with breast specialism, or waiting with my perforated duodenum for another surgeon to 4785 become available, it would not have been a choice.

I am delighted to support the amendment, which I think does it all.

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might be more convenient for them, it might be that they will respond to their constituents, but with a copy of the letter for us, but that is in your service in this Court, sir.

That was never the way. It is not the way across Government. If that is to be Government’s way – that the MHKs cannot represent their constituents – then make it across Government. Do not do it piecemeal. Do not do it in presenting issues like medical care, which are understandably 4975 very anxiety provoking for those individuals and their loved ones at that time.

I hope that that message will be taken on board. I am looking to the Chief Minister and to the Health Minister, because this is the Government which has introduced that practice, that policy, and this is the change I have seen in my short time in this Court. I am sorry that the hostility from the Chief Minister is the response we are receiving. So, what to do? 4980

The Department has had the opportunity to counter some of the… or to better tell their story. They are well resourced to do that. They are clearly well able to do it, when it suits them. It is very disappointing that message has not been coming through that, that clarity has been lacking, because that helps nobody, including themselves. Again, I can only ask that they reflect on that.

In terms of moving forward, I think that the two amendments before us in Mr Anderson’s 4985 name and enhanced by Mr Cregeen’s amendment actually go as far as giving us the confidence that the service is not to be diminished and, indeed, is to be enhanced. If that is the case – and I have no reason to doubt the health professionals when they have advised us about that… I do not doubt that for a moment and I do not doubt their commitment to enhancing the service and to maintaining the best possible service within resources. So I think that should be good enough to 4990 move us forward.

I hope that, as a Court, we will accept that, we will vote on that, we will look forward to the comfort the committee report will bring, but I do hope that, in doing that, the other message about allowing and encouraging Members to represent the interests of constituents and meeting with people… so not refusing to meet with other Members when they have a presenting issue… I 4995 cannot see how that could be helpful, certainly not in the circumstances we had it from either side, but with that change of attitude and that appreciation of trying to resolve issues between ourselves, rather than across the floor, I hope that we can support the two amendments, which will, hopefully, have that effect, sir.

5000 The President: Hon. Member for Onchan, Mr Earnshaw. Mr Earnshaw: Thank you, Eaghtyrane. As Mr Gill, who has just resumed his seat, has said, this is a sensitive issue and it is a great

shame, I agree, that it has ended up where it has today, on the floor of this Hon. Court, but there is 5005 more to this motion, in my mind, than meets the eye.

I would like to lead the thoughts of Hon. Members in another direction because the issue, to me, is who runs the Hospital. Is it to be the Minister and his officers, or is it to be pressure groups? If it is the latter, we are in trouble.

Eaghtyrane, I am on my feet today to represent cancer charities on the Island. I chair the 5010 Island’s Council of Cancer Charities and have done so for the last five years. The CCC, just for the information of Hon. Members, represents nine charities. It represents Isle of Man Anti-Cancer Association, Manx Cancer Help, the Anthony Nolan Trust, Hospice Care, Breakthrough Breast Cancer, Bowel Cancer Isle of Man, Breast Care Isle of Man, Macmillan Cancer Support and the Isle of Man Lung Cancer Foundation, and today I am representing all those charities and speaking 5015 on their behalf.

The first question I want to pose is: who becomes involved with these charities? As often as not, it is people who have personally suffered the disease of cancer or someone who has cared for a loved one who has succumbed to the illness. Their sincerity and commitment to the charities they support are unquestionable. Why do they do it? Invariably, it is to help others who may suffer 5020 cancer in the future. What do they do? The answer to this can vary. Much depends on the particular skills of the individuals concerned. It covers such things as the vital ingredient of fund raising, which can take many guises, but it also covers, crucially, support by way of counselling for patients recently diagnosed, as well as those undergoing treatment and those who are, hopefully, recovering from the illness. 5025

Considerable skills are required to do this and most patients being counselled derive great comfort from talking to someone who shared their own personal experience.

Some of the charities I am representing today provide many additional services to these and Hon. Members will be well aware of the good work undertaken by Macmillan and Hospice Care, the two largest charities represented. Most involved with the charities are volunteers. Many work 5030

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tirelessly, year-in and year-out, for others. Many make a lifelong commitment to these tasks and their driver is caring for others.

All the charities I have mentioned have been involved over the last few years in working up a better cancer charity for the Isle of Man… better cancer strategy, I beg your pardon, Eaghtyrane – a better cancer strategy for the Isle of Man. It has been a long and, at times, arduous road. Funding 5035 has not always been easy to come by from the Department. The Department of Health have competing issues from other parties, other charities who want to push their case, and there is a balance the Department has to strike.

One way and another, the cancer charities have achieved success and, as Chairman for the last five years, I am pleased to have been a part of that process. I like to think we work in partnership 5040 with the Department and I believe we have an appropriate level of trust and understanding between us. We have a good relationship. I know, in fact the charities all know as well, that they cannot do everything all at once, but by working with the Department we are achieving some solid outcomes and I am grateful to the Minister and his predecessor for what has taken place during my time. 5045

So let us examine what has been going on with the action group, headed by Mrs Cannell. What has been the impact on the charities of their actions? To begin with, the charities not directly involved with breast cancer view the action of the group as extremely selfish and aggressive. To them it has been a ‘me-me-me campaign’ and we should be mindful, Hon. Members, that cancer can strike any part of the body, and it does. Why, therefore, should a dedicated surgeon be 5050 employed for breast surgery, rather than, for instance, bowel cancer? The same, no doubt, goes for other illnesses

For those involved with the breast cancer charities, the impact has been much closer to home. The charities are populated by the caring people I referred to earlier. They are not politicians, but they have been dragged mercilessly into a political scrap. (A Member: Hear, hear.) 5055

Thankfully, they have had the toughness of mind to resist the pressures which have been put on them, unfair pressures; but it has had an impact and it has caused damage to the charities concerned, an unintentioned damage, perhaps, but the outcome has been felt from the many who have signed the campaign petition Mrs Cannell has run.

I do hope the damage caused will be repaired in time. 5060 Mr Henderson: What damage? Mr Earnshaw: It is not deserved and it will take some time. 5065 Mr Henderson: Give us some evidence, Adrian. Mr Earnshaw: I now want to mention the public meeting at the Manx Legion Club a little

while ago. Personally, I was surprised that attendees were invited to sign the petition on the way in. Many signed, but my surprise came from the fact that they were invited to sign before hearing 5070 the arguments for and against.

Once inside, I listened to the cases being put by the two parties. I do not know the current jobholder, Miss Hamo, who works for the hospital as a locum, but what was clear is she is greatly appreciated by patients she serves. This is understandable. If you are diagnosed with cancer it is, at least for the vast majority, a shattering experience. I have a lot of personal knowledge of this 5075 illness through my own family.

Those who believe their life has been saved, however, regard the surgeon as their saviour; but that, when you think about it, is the job of the surgeon. They are professionals and their function is to save lives, not to lose them.

Miss Hamo is doing her job and I can perfectly understand how much her patients think of her. 5080 The point I am trying to make here, Eaghtyrane, is that others can fulfil this role just as well as Miss Hamo, however good she may be, however popular she may be. As a professional, she is simply doing her job, and this has been the consistent message of the Department.

At the Legion Club, my colleague, Mr Anderson, endeavoured throughout the evening to get his point across that the advertised job for a general surgeon with a specialism in breast care would 5085 not result in any diminution of the service provided to patients at Noble’s Hospital. Sadly, the message seemed to be falling on deaf ears and few were interested in listening. All evening, he met hostility and I felt he was continuously unfairly rubbished by a variety of contributors. The joy of politics! All this is a shame. In my view, Mr Anderson is an upright man who conducts himself properly. He is a decent man and he is an asset to the constituency he serves in Glenfaba. He has a 5090 tough job to do as Minister for Health, and running the Department of Health is not an easy task.

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Eaghtyrane, I want to summarise the views of the cancer charities. All have been united in their support for the Department. At the CCC our medical adviser is Professor Howard Scarffe, a retired distinguished oncologist. The Isle of Man Anti-Cancer Association has among its number Mr Malcolm Clague, the former breast surgeon at Noble’s Hospital. Writing in Isle of Man 5095 Newspapers this week is his twin brother, Dr Roy Clague, who retired from his position of consultant physician in rheumatology at Noble’s.

We have the full support of other professionals. Between all the cancer charities I have named, plus the medical professionals, we have all supported the direction of travel of the Department in this matter. We are united. We cannot all be wrong. 5100

Hon. Members, this sadly has been a bitter issue and a lot of hostility has been evident towards the breast cancer charities and some others. I am not going to attack the action group for their efforts, Mr President, other than to say they have been, in my view, misled and egged on by Mrs Cannell, the mover. The time has now come, however, to draw a line under this matter and move on. We need to do this in the interests of patients who will have suffered many fears and 5105 uncertainties over this matter at a time when they are particularly vulnerable.

Now we come to the two amendments. I will be guided by the Minister regarding this. Personally, I would like to vote against the motion as it is presented on the Order Paper, because I think we are getting in rather a muddle with the amendments that have been put before us. I am not sure how helpful he sees the second amendment that has been put down. The first one is his 5110 own. I will certainly support that. I will listen to what he has to say about Mr Cregeen’s motion when –

Mrs Cannell: Amendment. 5115 Mr Earnshaw: Amendment, later on. The point I was to make, Eaghtyrane, overriding this, is let’s make sure it is the Department of

Health who run the Hospital and not anybody else. The President: Mr Malarkey. 5120 Mr Malarkey: Thank you, Mr President. I had not really intended to speak this evening, but it is a very emotive subject and very late in

the day we got given a presentation at lunchtime with regard to where the Minister stands with this. 5125

Over the last few weeks, with a very open mind, I went to the presentation that was given down at the Legion Club. I have had letters, like other Members had, from constituents and made a point of actually going and sitting and speaking with constituents, rather than trying to talk to them on the phone to get a feel as to where the emotion was coming from and what their views were. It is a very emotive subject. I think cancer probably affects the lives of every person in this Hon. 5130 Court tonight. Somewhere down the line we know somebody, we know of somebody’s family, or it may be part of our own family. It might not necessarily be breast cancer, but cancer certainly affects people’s lives.

My own mother was diagnosed with cancer in 2002. After surgery, the family was quite upset to find out that the prognosis was that only 10% live over two years. At the time the surgeon who 5135 did the operation, Mr Paige from Broad Green brought the news to us and we were obviously quite upset about it. I am happy to say that she got the all clear some seven year later and my family actually believed that that man could walk on water because he had done such a fantastic job and we got eight more wonderful years with my mother. So it does affect everybody, Mr President, in all sorts of ways. 5140

When I went to speak to my constituents and listened to some stories, just like I have given you, heartfelt ones, and how grateful they were to Miss Hamo, who I have never met but I believe she can walk on water on some of the stories I have been hearing, on the service that she has been giving on this Island, I can understand why the emotion of the gallery and people who like her so much… I truly do, but I have to be realistic as to what we have to do as parliamentarians in here 5145 and what Government policies are. Government policies are we have to advertise this job. Believe me, I do not believe in locums. I have found out through my own Department how much, through mental health and other areas, locums cost taxpayers dearly, so I do believe that this job has to be filled and filled permanently, if possible, and there is a procedure to go through to do that.

So the real discussion of today is down to job description. The argument I have had with my 5150 constituents, at the end of the day, is I will not vote for anything that is going to make the breast cancer surgery in the Isle of Man less than what we have today. I will not come into this Chamber

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and vote for anything that is going to demean that service that we already have. Whether it is with the present consultant or whether it is with a different consultant, I want to hold my head up high when I walk out of this Chamber tonight, knowing that the service is not only going to be as good 5155 but probably better, and if I am not happy here and here, I will not be voting… I would vote for Mrs Cannell’s motion today.

Come lunchtime today, I had an opportunity to ask some questions that I had not had an opportunity to ask before. I do think the Minister was rather late in the day and I think, had this happened a lot earlier, a lot of information that has been flying around could have been squashed a 5160 lot earlier and I do not like when this Government comes to us at the 11th hour and starts giving us the real facts. It should have been done a lot earlier. But I do say that when I walked out of that meeting today I was a lot happier than I had been. I had a chance to ask the experts, get some information, the information that was not clear in my mind, information that was flying backwards and forwards from Departments, from circulated letters, from e-mails. As laymen, how are we 5165 supposed to take what is true and what is not? We are talking about surgeons here. We are talking about specialists who have spent a lot of time training to do these jobs, specialising in things.

The first thing I wanted to know is when the present locum took the job, what was her job description then? Was she just a specialist in breast cancer? We got told today, most definitely, she was a general surgeon who specialised in breast cancer. She was not solely a breast cancer 5170 surgeon. That cleared one point up for me. We were also told that she had, since taking the post, to get rid of the backlog, specialised in breast cancer. We also got told she is still recognised as a general surgeon in breast cancer, as far as the Medical Association is concerned. So she is more than allowed to apply for this job. There is absolutely nothing stopping her, even with the present job description, going for this job. 5175

I think what I am trying to get at, Mr President, is I have come to the conclusion today that certainly the service in the Isle of Man is not going to be diminished in any way. I think it is going to be enhanced. I have always had this problem with this 80%, 20%, 60%, 40%, who is on call, who is not on call, but it was described to us with a little chart on a little piece of paper today on a wall, which made it a lot clearer to us. It was a lot clearer to us because we had not had this 5180 information before. It had not been forthcoming.

The two amendments coming through this evening, I think, say it all. I think I am inclined to go with the Minister’s amendment on one condition: that the amendment by Mr Cregeen goes with it, because this makes them accountable and then it has to come back to this Court, whether we are all here or not – I do not know after the Election – but this debate will be on Hansard. The 5185 promises made by the Department will be on Hansard and we will be able to come back, hopefully – I say, hopefully – after the Election and hold the Department to account because clearly everything it says and the Department has promised in here today, if this amendment goes through, it will have to keep.

So, as I said at the start, Mr President, I have no intention of voting for anything that does not 5190 enhance what we already have and I believe after lunchtime’s debate and discussion and the amendments before us this evening, I believe that we will be able to hold the Department to account.

The President: Hon. Member for Middle, Mr Quayle. 5195 Mr Quayle: Thank you, Mr President. I do not doubt people’s genuine fears and concerns in relation to this very serious matter. There

can hardly be anybody in the Isle of Man who has not had family members or friends affected, and that certainly includes me, but I do think the petition, as well-intentioned as it was, did rather point 5200 to an outcome which would encourage people to sign it, because the very first line of it says:

‘ The annual number of breast cancer cases has exceeded 90 for the first time, yet David Anderson, MHK, the Health Minister, is planning to downgrade our dedicated breast surgeon.’ 5205 So immediately people were getting the impression that the whole service is being

downgraded. Yet, if we look at what has now come forward as an amendment, if I went round to each and every person who signed that petition, several thousands of them, and if I came up with the petition that said, ‘I support the Department of Health ensuring that the breast care service is maintained and enhanced to ensure that there is no diminution in the present level of service 5210 provided within the Island and supports the Department continuing to provide a dedicated breast care service led by a surgeon specialising in breast surgery, thereby securing the service provided to patients’, I do not think there will be many people out of that several thousand who signed the

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petition who would not have signed that particular petition if it was raised in that way – but that is the amendment that we have with us, before us tonight, which I will be supporting. 5215

I think I would also like to put on record my appreciation to the Minister for the information and briefing today and the full explanation given by himself, the officers who were there and the professional officers who were there, too, which hopefully will have done much to reassure people who attended.

The one thing I would say is there has been criticism about the lateness of that briefing but, in 5220 fact, as I understand it, it could well be that it was held pretty quickly in response to the information – a huge amount of information – circulated by Mrs Cannell in a letter dated 16th June – only received then, presumably, last Friday. So for the Department to have analysed the information, sought to provide, then, the clear, correcting information of the inaccuracies that were contained in some of the information distributed, that is why we had a presentation today. I think 5225 that is self evident.

Just in relation to the amendment from the Hon. Member for Malew and Santon, Mr Cregeen, before seeing his amendment, I had actually written down a note saying that, as a commitment on behalf of my constituents of Middle, many of them who I know signed the petition and, indeed, across the Island and, hopefully, if elected, I had a note here that I would continue to monitor the 5230 situation to ensure that improvements actually happen. I know we have got the amendment from Mr Cregeen, which obviously, then, puts it in the hands of the Social Affairs Committee, but I am also equally aware, as we all are here in Tynwald, that the Tynwald Policy Decisions Report also would have been obliged to give an update from time to time about how the Department of Health was dealing with this particular motion that, hopefully, we will agree tonight. Having said that, I 5235 know the extra amendment that has come forward… I am more than happy to support that because it is only doing really what I think the Tynwald Policy Decisions Report also would have done.

With that, Mr President, I think the final thing I would like to say is, unfortunately, there are several thousand people who signed the petition who will not be privy to the briefing that we had today, who will not have had all the information and explanations that we have had today and in 5240 recent weeks when we have been individually clarifying matters with the Minister for Health – and I thank him for that. So it is unfortunate that by the petition being signed in a way by the several thousand people, they will not all be listening tonight and will not get the detailed explanation that we have all been privy to, that people in the Gallery have and, of course, those who are listening to Manx Radio. I just think we somehow now need to ensure that those across the Island get similar 5245 reassurance, particularly those who signed the petition, because they are the ones who have a presumption that the service is being downgraded, when, in fact, there are fantastic enhancements that are being pledged to us.

Thank you, Mr President. 5250 The President: Hon. Member for Douglas West, Mr Corkish. Mr Corkish: Thank you, Mr President and Mrs Cannell. In beginning my contribution to this debate, I may say that I do not speak from a totally

detached position but I am involved in the area of cancer care and research as Chairman of the Isle 5255 of Man Anti-Cancer Association referred to by the Hon. Member for Onchan, Mr Earnshaw, an Association which, for 50 years, has raised many millions of pounds for research and care not only in this area, but for many areas in cancer research and help.

I do regret, as other people have said, Mr President, that this emotive and sensitive subject has become so public and that the excellent, valuable and life-saving work carried out over a long 5260 period of time by gifted and dedicated professionals in this particular field has become somewhat, perhaps, forgotten and almost overlooked.

Such is the role of politicians that, sooner or later, and probably often, we will be compromised in our deliberations on issues that come before us. The Members of this Hon. Court sought office to help, assist, facilitate and give to our Island wherever we can to the best of our ability – it 5265 sounds a little corny, but there it is – and we take advice, where possible, as has indeed the Minister for the Department of Health. I therefore seek some clarification, as much as possible, to add one or two points on this issue for our consideration in this important debate and irrespective of who is moving this motion.

Can I just refer back to the advertisement, just to clear up my perception and view of this, the 5270 original advertisement placed. It was said by some that it was a general surgeon with an interest in breast/urology. This is completely incorrect. As I understand it, the job description clearly states a consultant surgeon with a specialist interest in breast care.

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There is no urology surgery, as such, involved, except as part of the normal general on-call rota, which will, in theory, cover urology, but in practice a consultant urologist would be called in 5275 for emergency work. There has been assurance by the Department and the hospital that this post is for a specialist breast surgeon with a small proportion of their remit for general surgery on-call work.

The increase in cases that Mrs Cannell quotes as an alarming rise in cases is largely due to the expected increase in cases following the introduction of the call-recall screening services, of which 5280 service the Isle of Man Anti-Cancer Association was instrumental in starting and part funding. Most of these are very early cancers, or in fact pre cancers, which are eminently treatable. The numbers currently being diagnosed are showing a decline back to our normal rate of approximately 60-70 cases a year and they are unlikely to go above the peak of last year, according to both Malcolm Clague, now retired, and Dr Peter Evans, who was the resident 5285 radiologist.

The information the mover of this motion has given to both Chris Holcombe and Mr Rainsbury, President of the Association of Breast Surgery in the UK, may have been thought to have been skewed to suit her case. For instance, she attributes all of the new innovations in the breast service, such as call-recall screening, breast care nurses, MDTs etc, to the present locum 5290 consultant. This is totally incorrect, as all the aspects of the service she mentions were introduced by Malcolm Clague, and some many years ago.

Two of the Island breast cancer charities, together with Isle of Man Anti-Cancer Association, as I say, were very involved in campaigning for the call-recall service.

Mr President, I believe the action group and Mrs Cannell are incorrect in their statement that 5295 the present locum consultant is a breast specialist. She is, in fact, a general surgeon with an interest in breast care, and that was her last locum post. In the Isle of Man, she is, doubtless, grateful for the fact that she does not have to be on call. The local consultant at present has considerable administrative time in her working week and also spends a number of Fridays in Liverpool for training sessions, thus keeping her skills level up, and all paid on a locum basis at a significant 5300 cost.

A dedicated breast centre requires a population of 300,000 to 350,000 and at least 150 newly diagnosed patients a year. We are nowhere near that figure in the Island. The proposed post is in keeping with other towns and areas in the UK of similar size, or often considerably larger, where the breast surgeon has to cover general surgery on calls. In an ideal world, and mentioned by Mr 5305 Rainsbury, breast surgeons would prefer to concentrate 100% on breast surgery, but in real terms and finance this is only happening currently in the very large centres. Towns such as Cheltenham and Chichester have consultant general surgeons with an interest in breast care as their title but, in effect, they are specialist breast surgeons. The action group and Mrs Cannell have apparently not taken this fact on board. Mr Rainsbury refers to a patient referral of 25 per week, most, of course, 5310 thankfully diagnosed as non cancers, and as being expected by a population of 300,000, and requiring two surgeons.

In the Department’s job description is the provision of a named permanent specialty doctor to support the new consultant post – not mentioned by Mrs Cannell, I do not think – and to participate in the on-call rota. 5315

Mr Rainsbury further quotes a current figure of 190 per 100,000 and increasing, which is approximately 50 a year for our population, as has been mentioned earlier. We have a higher rate than that, but similar to the north west, which is higher than some areas in the UK, and would not indicate that our figures are going to rise above 100, as I think Mrs Cannell predicts. There is no way a similar sized population in the UK would have anything different to what the Department 5320 are proposing.

The breast service needs a permanent member of staff to develop the service on a permanent basis. The locum consultant can leave at any time, giving very little notice. She may also retire. Her age is uncertain – I am not sure of the lady’s age – but, either way, she will not be planning to be here for long, especially as she lives in London, I think. 5325

The key steps which Mr Rainsbury congratulates the Island on were all put in place at a time when we had a general surgeon in place with an interest in breast and they were not as a result of us having a specialist surgeon. Mr Rainsbury makes the point that breast surgery is becoming more specialised, as indeed Mr Speaker alluded to earlier – ‘specialised and sophisticated’ I think he said – rather than less. Where does it all end? Do we end up needing three different breast 5330 specialist consultants specialising in different aspects, or three different consultant pathologists specialising in different types of pathology, or three different oncologists specialising in different oncology? We need to have a sustainable solution for the future. The fact is that the Island is never going to be able to afford this trend towards increased specialisation, with a population of 82,000.

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Mr President, we have been well and worthily served by our breast care surgeons in the past. 5335 The Department of Health repeatedly, and I believe honestly, say that this level of care will not diminish. No reduction and I, like many people and, in fact, all of the Members of this Hon. Court, would not support anything less. (Members: Hear, hear.)

There are, and there will be, many watchers, both within this Hon. Court and without, who will ensure that the promises made in respect of this important and emotive issue, amply illustrated by 5340 the number of public in the gallery present in this Court today, will be kept and honoured.

Can I just add that my charity has an excellent working relationship with the Department of Health that will continue.

Mr President, I will be supporting the amendment in the name… or I would like to support the amendment of both, echoing what Mr Malarkey, the Hon. Member for Douglas South, has said, 5345 that the Department of Health amendment is a good one; but I would like to see the amendment in the name of Mr Cregeen of Malew and Santon also in plurality, perhaps, with that, to ensure that what we expect, and I believe will be honestly given by the Department of Health, will be honoured.

Thank you, Mr President. 5350 The President: Hon. Member for Onchan, Mr Karran. Mr Karran: Eaghtyrane, I think it has been a very interesting debate. I came into this debate

this morning with the idea that maybe one should totally support the Government on this proposal, 5355 but I am actually more concerned now than I was before because what concerns me is the likes of… We did have the presentation, we had almost half an inch of papers given to us at dinner time, and there were some interesting contributions within that, but we have got no opportunity to actually go and talk to those individuals about the contributions that they have put in black-and-white. 5360

I think that the issue should not be about who signed what. I think what we need to do is work out what is right and what is wrong, and I have to say that I have found it very difficult to work out what is fact and what is fiction, as far as this debate is concerned. Little things concern me. We are told that there is not a downgrading of the service, which is a full-time service, but now it is going to be 80% of the service that it was supposed to be. 5365

I know that you defy logic in this place, on an item-by-item basis, and we can pogo on our heads, and I might be only a humble person who started his academic life in the Sunshine School at Pulrose, but the fact is if we have got a full-time service and we are told that we are going to end up replacing it with 80% of a full-time service, then that is a downgrade in anybody’s logical argument outside this Hon. Court. 5370

I also think that it is important that, whilst sitting next to the Chief Minister, we understand that the amendments have got the ‘royal prerogative’ as far as the support as far as these amendments are concerned, so there will not be any revolution as far as these amendments are concerned. My only concern is who will be on the Social Affairs Committee, allowing for the fact that we did see an improvement on the fact that what was proposed at the last House is a revelation compared to 5375 10 or 15 years ago, when the moon would have fallen out of the sky for such proposals.

I think that we do need some clarity and, unfortunately, the Minister has not got the right to reply. I was quite shocked that people who have been here not only five years, but even longer, do not seem to realise that on an amendment they do not have the right to reply, as far as an amendment is concerned. I hope that Mr Butt will be replying to the points that are raised because 5380 I do think we need to know that. If we are told we have got a full-time post now and we are then told that we are going to have a full-time post but 80% of that post is going to be filled, then it is a reduction in service. We need to be clear, we need to be straight and we need to stop the lhiam-lhiat-ism. We understand within the Court that we are in a difficult situation, as far as this debate is concerned, but we should not be trying to define the situation where we are trying to turn black 5385 into white, and I believe on that point alone… I think that needs to be clarified.

I have to say that I am very pleased that when we talk about the medical service today it is a far better medical service. When I remember, as a Member for Health, the situation we were not even allowed any representation on the theatre users’ group, so we had little control over the interventions and the activity lists, as far as theatres are concerned. I am really pleased that, whilst 5390 it has not gone far enough, I have a lot more confidence in the structure and I have heard reasonably good viewpoints about the medical director and that the situation is that it has improved out of all recognition.

What I have to say, as far as this debate is concerned, is I think that is something that we need to clarify, Mr Butt. Let’s be honest about it. If it is a downgrade on the service and we cannot 5395

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afford it, then let’s be straight about it, but let’s stop this ‘economics of La-La Land’, as far as the situation is… If this is being done partly on the basis of financial problems, then let’s have that clear and understood one way or the other.

I would also like to just say that I am concerned – and I am sure that I have no fears – that we have some absolutely fantastic consultants within the hospital. We have got some absolutely 5400 fantastic consultants who are a real asset to our society and a real honour and pleasure to our society, as far as they contribute well to us. What I am concerned about is I do hope that this is an issue on the basis of professionalism and not personalities, as far as this whole affair is concerned, because it does worry me that that is one thing that does concern me as well. I do hope that we are finding a situation, as far as this issue is concerned, after the Hon. Member of Council, Mr Butt, 5405 the Member for Health, clarifies the point of how a full-time post becomes an 80 % post, but then it is actually an increase in the services.

I think the other thing that needs to be made sure of is the fact that we are doing this on the basis of professionalism. I have to say, Eaghtyrane, as far as the Health Service is concerned, it is far better, it is more accountable than it was when we had no control over our consultants, as far as 5410 input is concerned, on a number of issues, and in many cases there should not be the waiting list there is in the hospital. We knew that when I was Member for Health but was not Minister. I think it is important that we must make sure that this is being done on the best of professional clinical advice, as far as this is concerned.

Those are the only two caveats I have got that I want the Member for Health to sort out, 5415 because I am very, very concerned because there will be decisions that will have to be made in the future. This needs to be clarified, that it is not a financial issue and it is not a clash of personalities as far as the present people.

We are all against locums. We want to change. What we have to do, Eaghtyrane, as a former Member for Health, is manage to develop the strategy, as far as our Health Service is concerned, 5420 that it is not a cul-de-sac, coming to live on the Island, for people’s careers. Many of the things have been fought on, as far as trying to keep an element of teaching within the Hospital in the past and I do feel that that is a problem that we have got.

What I am concerned about is here we are today, we get a presentation, we get some letters on which I would have liked to have been able to go back to the individual, because I have the highest 5425 regard for him, just to clarify a few points. If we are doing this debate today on the grounds that it is efficiency and effectiveness, then we need to clarify those points. If we are doing this thing today because of the economic situation, the people outside this Hon. Court need to be informed, as far as that is concerned.

As far as I am concerned, I am quite happy to see the Hon. Member for Santon and Malew’s 5430 amendment going forward. I think we have come a long way with the proposals that came at the last sitting, which I congratulate… [Inaudible] on, which were so impossible so many years ago, that now are acceptable. But I do think that we do need the Department to come clean, as far as the issue of whether cost is leading this or whether it is the service that is actually leading this requirement. 5435

The President: Hon. Members, I am conscious of the clock. It is my desire, Hon. Members, if

practical, to finish this debate this evening. (Mr Houghton: Hear, hear.) I have to tell you, Hon. Members, that I still currently have four Members wishing to speak

before I invite Mrs Cannell to wind up. If you are conscious of that, Hon Members, I am quite 5440 prepared to continue.

Mr Anderson: Mr President, point of order. Could you clarify for the Hon. Member for Onchan, who has just resumed his seat, that I do

have the right to reply to an amendment that has been put on the floor of the Court, since I moved 5445 my amendment?

The President: You can speak to the amendment later, sir. Mr Butt, Hon. Member. 5450 Mr Butt: Thank you, sir. Mr President, I will start by addressing the concerns of the Member for Onchan, Mr Karran,

about the workload and the job plan. Firstly, can I assure everybody in this Court that this application to provide a new consultant

for breast care is not driven at all by politicians or by our senior civil servants in the Department; it 5455 is driven by clinical need and at the request of the clinical staff.

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Secondly, it is also nothing to do with money whatsoever. Since Mr Malcolm Clague retired, the breast care service has needed some direction. He, as Mr Corkish said, did set up all the things in place now. He set up the teams and the staffing as it exists now. He was the man behind making the breast service the modern system that it is now but, once he retired, he had to be replaced. In 5460 the short-term, a locum was appointed. Unfortunately then, I think for nearly three years, the Department has not managed to resolve that situation and now we have come to the point where it is being resolved. It has not been driven by cost.

In the last few months we have had many, many debates over this about how we go forward with the breast care service given to us by the clinical staff. There was to be a three-year plan to 5465 improve the service. The first was to appoint a consultant to lead the three-year plan. The second was to bring in sentinel node biopsy, and the third was to bring in, where possible on the Island, breast reconstruction. That was a three-year plan.

Mr President, while that has been being formulated, we have fought to find funds to do that. To bring in sentinel node biopsy is going to cost money. To bring in breast reconstruction on the 5470 Island is going to cost money. Obviously, to pay for a consultant surgeon is going to cost money. This is not cost neutral. I think Mr Speaker said that it is cost neutral. It is not cost neutral. This will cost money, and within the Department we had quite a battle to find the money to achieve this.

If I could just move on to the current workload, which answers Mr Karran’s question, the 5475 current locum has a job plan, which I think has been circulated to Members earlier on. In the job plan, there is one theatre per week of four hours. In that theatre, two to three patients per week are dealt with. The current locum has a 30-hours-a-week direct clinical commitment – that is 30 hours per week. The locum is actually contracted for a total of 62 hours, of which 16 are for emergencies. That leaves a spare 16 hours per week which the locum can work. In fact, the locum 5480 often goes across to England, most weeks, and works in Liverpool, and in Liverpool the locum keeps up her skills and provides a service in Liverpool, and we pay, as a Department, to send her over there to make sure her skills are maintained. So there is spare capacity within the post to provide the extra services. The current workload for the locum was busy when there were 90 cases per year being referred and there was a peak, because of the call and recall, where 90 cases were at 5485 the peak, or 93 cases.

On 12th July this year, Mr President, in the next two or three weeks, we are going to introduce bowel cancer screening, which I am very grateful to the Treasury and other people for being able to maintain for us. Bowel cancer screening is going to make a big difference to our workload, as well. Bowel cancer will kill about 25 people per year at the moment, and we will have the call-5490 and-recall system for that. We know and we are resourcing for that, that there will be, over the next two or three years, a big increase in the number of bowel cancer patients and the work that needs to be done to look after them – we will need extra staff and facilities – but we do know, and it happens everywhere where there is a recall system, those levels will go back down roughly to where they are now. 5495

Mr President, I am convinced from the figures we have before us this week that, so far this year, 26 cases have been diagnosed of breast cancer and it is quite likely that, by the end of the year, it will be around about 60. The plateau has been reached and is now coming down.

I was interested to hear what Mr Speaker said about the rate of cancer increasing over the years. I think he said that, over a 12-year period, the rate will increase 119 per 100,000 to 124 per 5500 100,000, and that equates in 100,000 to five extra people over 12 years, if what he said is correct. That means in the Isle of Man we are perhaps talking about four extra people over 12 years that are likely to come through to us with breast cancer. There will be increases because the population is ageing and there will be more people living longer who will become afflicted with breast cancer, but that will be on a gradual rise, as with the gradual rise in the age of people living. It is not going 5505 to be unmanageable and, as time goes on and we need more resources, we could then bring them in.

If I could just talk about the new workload which Mr Karran has an interest in, as well. We had a presentation at lunchtime, for those who were there, which showed that, at the moment, there is one theatre per week and we intend to increase that to two theatres per week – two four-hour 5510 periods. Of that second theatre, in theory, 50% of that will be for general surgery. In practice, if needed, it could be used for breast surgery. So even at the very minimum, there will be a 50% increase in the amount of theatre time available for the breast cancer surgeon.

In addition, there will be, by the terms of the job description, an enhanced medical team to support this breast surgeon. So there will be more resources in terms of people and medical team 5515 to work with the breast surgeon. I think Mrs Cannell quoted a comment from one of her experts

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from across, that it is likely to be 50-50 in terms of general surgery and breast care; in fact, the reality is, it will be 80-20 in favour of breast care.

If I can just turn to the supervisory element of being on call, Mr President, I make no direct comparisons but I have spent a lot of my life on call and I know what that means. You have to be 5520 available on the phone to give advice or attend, if necessary. I was not there to save lives; I was there for other reasons. These people, surgeons, have a very important role. We heard today that when you are on call as a surgeon, on the on-call rota, your job is basically supervisory. You are at home, but available. You give advice to the team who actually are working in the hospital, doing the surgery, dealing with the emergencies. We were told today by Mr Steve Upsdell, who I have 5525 ultimate faith in, that the person on call would very rarely get involved in actual hands-on involvement in the hospital with the surgery, unless there were some dire emergency. The person is on call to give advice and provide advice to the team who are there, who are doing their duty, anyway. We are also told that there are between 4 and 4.5 episodes per day of emergency admission – not all of those end up in surgery. Only a small proportion of those will actually need 5530 surgery.

Mr President, can I just turn to the current locum. This is not about the locum and it should not be about the current locum. It is about the position that we need to fill. I do understand, and I have had people say this to me personally, that the current locum is very popular with her patients, very sympathetic with people, and breast cancer patients find her a boon to them in their struggle for 5535 what they are trying to go through. But, Mr President, that person is a locum and we cannot rely on a locum to lead the service through into the future. A locum, as somebody else said earlier, can go at any time at fairly short notice and we would be left with a big hole to fill, and I am sure, if she did go, she would leave a big hole. It is very important to point out and keep saying that that locum is a consultant surgeon with a specialist interest in breast care. That is her grade, that is her 5540 rank. That was her rank when she arrived here in the Isle of Man – that is still her rank and still her grade. She is able to apply for this job: she fits the criteria exactly. There is no reason why that person should not apply for this job. She is experienced, she is of an age where she could perhaps lead a team, she has the expertise.

I would just make another point, sir, about that. The selection panel for this post will not be me 5545 or politicians or senior civil servants. The selection panel will be medically qualified people and they will include a member of one of the breast care cancer charities. A lay member will be on that appointment committee to decide if this person, whoever it is who is appointed, will be suitable, as far as the charities are concerned. I think it is very important to bear that in mind.

I would just like to make another point about the cancer charities. We have had mention of 5550 those from two Members. I know that Sharon Maddrell, who is the Chairman of Isle of Man Breast Care, was initially opposed to what we are trying to do. She spoke to us and spoke to our medical experts and she put a letter into the paper where she basically said the problem with this issue is the terminology of what the post is described as. A lot of it is to do with that.

Sharon Maddrell, Mr President, is an advocate and when I used to prosecute in the courts many 5555 years ago –

Mr Houghton: She is not. You are mistaken. (Interjections) Mr Butt: Oh, sorry. Apologies then. 5560 I was going to say I thought she was the advocate. Apologies, Mr President. Mr Houghton: Postmaster, Ramsey. Mr Butt: Right. Well, I do hope that Sharon Maddrell, who is referred to in this, is not the sort 5565

of person who would be easily persuaded by the Department to roll over and just take what we say at face value. I am sure she is independent enough to actually make her own mind up and make her own decisions on that.

Mr President, I think the main point of this is, which is mentioned again by somebody else, who actually runs the Health Service? The Minister is responsible for the Health Service – that is a 5570 given and there is no doubt about that – but the actual clinical running of the day-to-day operations of Health have to be done by experts.

If we were to support this motion today, which I know is a popular idea from a lot of people, it would actually mean that Tynwald would start to run the Health Service. Tynwald would have to make decisions on how things are run and Tynwald, believe me, would have to find an awful lot 5575 more money if they decided they would run it. Every day, or every year, in the Hospital, hundreds of decisions, or maybe thousands of decisions are made by the staff in the Hospital and the Health

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Service generally, some of them life and death decisions, but all of them will be about quality of care for people. Those decisions are made, day in and day out, by the experts and clinicians and they should be left to do that. We provide the finance and some policy and direction, but we 5580 should provide no more. Tynwald should not be the body that decides on individual job applications or procedures as to what should happen. Surely, they should oversee on how the money is spent and are we providing a good service, but they should not be making the decisions as to who does what.

Mr President, I will just turn to a couple of points made by other Members. 5585 Firstly, to Mr Gill. He actually said the Department have been putting their message across in a

very poor way. Now that may well be true, but I do not think it is for a lack of trying. We have been putting our message across for months now and the recognised charities throughout the Isle of Man have listened and have understood and we have heard evidence today from two Members about how most of the charities have understood the message we are trying to get across and that 5590 we are doing the right thing.

There are some people who do not get the message or maybe get misinformed, and we cannot help that.

To Mr Malarkey I would like to apologise for the late briefing today. It is rather late and it has perhaps not given people enough time to read everything that is there but, in fact, it is because the 5595 proposer of the motion gave us a briefing on Thursday with some information and, for whatever reason, some of the information which we think that she gave was not as accurate as perhaps it could have been, and the people in England who responded to it were given, perhaps, different messages to what the actual facts were, and we had to respond to that. That was last Thursday. We have had a couple of days to go through the information and try to respond to it. So apologies for 5600 the late briefing today, but we did not have time to try to correct what were perhaps genuine errors by the proposer, but they were errors.

Mr President, I would just finally go on to say that, like Mr Malarkey, I would not vote for anything that would cause a reduction in this service. I would not do so. I have been in the Department for just over a year now and this has been a discussion topic for quite some time. I 5605 would never contemplate supporting the move that we are proposing if I thought in any way there would be any reduction in service. I am convinced, and I will guarantee, there will be an increase in service whoever we appoint as the consultant. Had I thought we were going through this for the wrong reasons or to save money, I would have left the Department and resigned. No doubt about that at all. 5610

Mr President, I will just reiterate a couple of other points: this is not a reduction in service; it will cost us money; we are not doing it to save money. I am convinced that there will be provided a better service with more clinic time, more surgery time, and we will have the ability, as things develop and as specialisms develop, to give more time to whoever is in the role to increase the service into the future. 5615

Thank you, Mr President. The President: Chief Minister. The Chief Minister: Yes, thank you, Mr President. 5620 I am not going to go over a lot of the points that have already been made, because clearly they

have been made very well by those who are contributing to this debate, but I do think it has been a really interesting and measured debate here today, which I think is important, because it reflects the mixed public opinions, in other words the different sides of the point that is being made by those who are concerned and interested in the whole subject matter. 5625

My view, as Members will know, is that I believe Tynwald is the right place, when there is such important public concern for us as politicians to debate the public issue and I believe that is exactly the right thing to do and this is the right place to do it. We have, thankfully, a position where our people can freely express their concerns on any subject matter without fear and this is one where that has clearly happened. I think we are all conscious of the amount of effort and work 5630 that has gone in by the Minister, his Department, officers and consultants and others to try and portray the case to those who have concerns, to try and settle them with what is actually going.

I want to make it absolutely clear that, not only as Chief Minister, but also as a Member of the House of Keys for my own constituency, I would not support anything that was going to reduce this service. My whole life in here and those of many of us, if not all of us, has actually been to do 5635 what we can to enhance the Health Service.

I think we are the only country in the British Isles that is actually increasing expenditure on health, when all the rest are cutting back and that is because we are trying to continue to develop

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and improve and create more effective services. So I think I would like to make that clear, and that is where I, and I know everybody else, stands. May I say that we all have the same objective here 5640 today and that objective is – and it is Government’s objective also – through the Department of Health, to continue to be committed to provide, at the very least maintain, the present level of breastcare service and to enhance the service as much as we can, whilst ensuring that it is, using Mrs Cannell’s words, safe and effective. Of course, that is what we want. None of us are arguing about that, and I think it is important that we make that point very clear. 5645

The paramount issue for us with our Health Service, regardless of the politics, is to ensure we can do the best for the patients, and that is really what we are trying to do. So we are committed, as Government, to ensure that we provide, as much as we can, the service that this Island needs. I know I have certainly done it and other Members have done it – listened carefully to many views that have been put to us by constituents and by others. We have listened to the debates, what has 5650 been said, we have read it through the press, and the Minister has been questioned numerous times by Members who have written to him, e-mailed him, phoned him, including myself, to get clarification on issues, and he and his staff have endeavoured to clarify it in the best way possible to help Members understand what is going on.

So I think the debate itself today reflects the interest that everybody has in this whole subject 5655 matter. Politicians or not, it does not matter. We, of course, have the duty, as Members of Tynwald, to represent the people of this Island and we are the ones closest to them, in terms of public service, who have to make the decisions where we can. I think it is important to make it clear, and we do have difficulty sometimes all, as politicians, to make it clear the separation between the job of the politician and the job of the professional. I think, as the Hon. Member of 5660 Council, Mr Butt, said, we do rely on professional advice and they have to make decisions in healthcare for the good of the patients, and our role is to have clear policies of what our objectives are and how they are then achieved and how we fund those objectives.

Can I just say that, again myself, I have no problem. I have been a Minister for Health and Social Security – many years ago now – and clearly then it was the same. We always like to move 5665 on from the locum, to get a full-time position. A locum is an interim measure. It fills the gap until we get to the stage where we can actually identify either the funds, and also have the ability because of support services that are needed for a permanent consultant… are put in place. That, again, comes back to the work that has been done already over a number of years.

As far as I am concerned, both amendments are fine. One from the Minister makes it clear that 5670 we are committed to continue to maintain the service; and the other one – the Hon. Member for Malew and Santon, Mr Cregeen – makes it very clear that it should be reported back by the new Scrutiny Committee. I have no problem with that. I am a big supporter of the Scrutiny Committees. In fact, it was the amendment I put that made some changes that helped, I think, make it better. That was supported by Tynwald Court, because I do believe, and always have 5675 believed, Tynwald has a role. Government has one role, and Tynwald has another role.

Tynwald is there to safeguard the public interest, if in fact, the Government is deemed to not be doing what it said it would or is going astray. Members who know me will know that my view has always been very firm on that. I have no problem with that amendment. I think it will be helpful, because there will be people who will continue to have a suspicion that, whilst we say this, we are 5680 actually not doing it. From my point of view and that of my colleagues – and I know of the Minister – there is no problem, because what we are saying is what should be put in place. If they are not being put in place, it does not matter who you are in here, representing the people of the Island, we want to know why it is not being put in place. The commitment is clear: we want to improve the service, have a full-time consultant and, where we can, enhance that service for the 5685 benefit of the patients and the people that we have a responsibility to look after.

So, Mr President, with that – and I am not going to spend much time, because most of the items we could all say have been said, and I think there have been some very good contributions that have actually put a lot of things on the table and, hopefully, have helped people understand what, in fact, it is that we are trying to do through the Government and, also importantly, that in 5690 fact Tynwald itself is supporting a way forward that will give us a better service in the longer term, sir. I hope Members will support both amendments.

The President: Mr Anderson. 5695 Mr Anderson: Thank you, Mr President. Speaking – Mr Karran: Point of order, Minister.

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This is speaking to the amendment – 5700 The President: Speaking to the amendment. Mr Karran: Not the right to a reply… 5705 The President: Speaking to the amendment. Mr Karran: People should realise that. Mr Anderson: Mr President, speaking to the amendment, I would like to just make the 5710

comment that I am quite happy to support the amendment adding to my own amendment, in the name of Mr Cregeen.

However, I would just like to point out one or two issues that Mr Cregeen actually raised in his contribution, when he said it was about holding the Department to account. I see this as the reporting-back basis to this Hon. Court through this Committee. He did make the point that if the 5715 consultant was appointed, as we advertise it, and then does not agree to any extra sessions, which all consultants do on a regular basis, we might be worse off than we are at present. That, quite clearly, is not the case, because the job plan is actually increasing the capacity to what was there already and we know that the capacity within the current job plan is not being fully utilised, anyway. So I have got no problem with that and I have got no problem with that Committee 5720 reporting back, because the Department has the intention.

I would just like to emphasise, in no way, shape or form is this actually a cost-cutting exercise, as Mr Butt has already pointed out. The supplementary staff who will have to go to support the substantive post in the future is something that we have had to argue with Treasury. We have had the support from Treasury for developing this area, and so in respect of that point of view, it is 5725 actually enhancing the service; more resources into the service at a very difficult time for Government. We are very grateful that Treasury had actually supported our business case.

In relation to the comment made by a few Hon. Members, that this is late in the day that we have made a presentation to Tynwald Members, we have been putting the same message out, consistently, for many weeks now. However, other information came forward and we thought we 5730 should respond to it in a timely manner. (Interjection by Mrs Cannell) That is what we have been doing. We have been responding to that.

So, Mr President, I am very happy to support the amendment that builds on the amendment that I put forward and look to the Court’s support.

5735 The President: Mr Crookall, Hon. Member for Peel. Mr Crookall: Thank you, Mr President. I doubt there is anybody in this Hon. Court that has not been touched by this, by their

constituents or family members, or whatever, and I just feel it is a shame that it has actually come 5740 down to this and needed this debate to clarify the situation.

If I have one criticism of the Department it is that it has taken them weeks and weeks to clarify the situation on where they are and what is going to be on offer when they advertise for a consultant surgeon. That said, I think over the last few weeks there have been an awful lot of accusations and misrepresentation going on, confusing figures put in the public domain. 5745 Irresponsible things have been said, as well. I think information has probably been used that it is now wished could be taken out if somebody could go back in time, but that is not possible.

But, as most Members have said today, everybody in here would not support any sort of a diminution in service, and that is what it is all about. What we have had now is clarity from the Minister and his Member from the Department and the team, at dinnertime, in the briefing that we 5750 have had, that that is not going to happen. That is not going to happen. We have their word on that and we have an amendment put through now by Mr Cregeen, which I hope Members will support, and I am happy to support that.

We have had confusing figures put in the debate about figures going up from 63 to 93, but we were not told by certain people that they were coming down again. They are coming down. We 5755 have been misled. The public have been misled.

Mrs Cannell: You have been misled.

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Mr Crookall: No, these were your figures. We had figures of 60,000 population in 2007. The 5760 whole thing has been messy, but now I believe we have some clarity from the Department and I am more than happy to support the Minister’s amendment, followed by the amendment by Mr Cregeen which goes on top of that.

Thank you, Mr President. 5765 The President: Mr Houghton. Mr Houghton: Thank you, Mr President. I would like to begin by paying tribute to the Hon. Member for East Douglas, Mrs Cannell, for

the hundreds of hours of work she has done in these latter few months, day and night. I know that 5770 because I have worked with her, worked alongside her and I know she has worked many times at home, in addition to all of that. The amount of work she has done and striven to get the information out of the Department and then having to look elsewhere, to other leading organisations, all that the Hon. Member has mentioned, goes to her credit and without question.

I would also like to pay tribute to Julie Stokes and the action group for having the tenacity to 5775 form an action group because they were getting no sense either and the action group themselves had been running themselves and briefing Mrs Cannell. Mrs Cannell has had nothing to do with running them. I know that and I can put that on record. So all these stupid, immature jibes that have been floating around tonight, shooting the messenger are completely unfounded. (Mr Henderson: Hear, hear.) 5780

Mr President, like the Hon. Member for East Douglas, I would like to give a contrary opinion, just to put a little bit of balance in, because the way the balance of the debate has gone, has been the other way, of course, although we are all reassured now, because the Department has come at the last minute with all its guns and reassured us. We are all now reassured. Why could they not have done that at the start? Why could the Minister not have met myself and Mrs Cannell, like Mrs 5785 Cannell so ably set out earlier in her opening remarks, to meet with the appropriate people and meet also with people who were in the public gallery this evening, who were most concerned and who were not getting the answers? Why could that not have happened – and do not come up with this: I have got a lesson; it is another lesson; they have learned another lesson. All I hear in this place is, ‘Oh, well, a disaster has happened, but we have learned lessons.’ We learn no lessons in 5790 this place at all. How sad an indictment that is.

Mr President, what I would like to say and just reiterate – all along what the Hon. Member for East Douglas has already set out in great detail – is the way the events went. I do not want to cover line by line on that and I do not intend to do that. But she pointed out u-turns in the appointment and the way it worked out for the appointment of a breast surgeon. She reminded you that the 5795 Minister said he was having a consultant, specialist breast surgeon to do that three-stage procedure that we heard; sentinel node and breast reconstruction in the third year etc. That has been heavily debated tonight.

Then for the question that she extracted from the Minister in November, it was a changed circumstance and that is when the suspicions started building up. The Minister did not want to 5800 know; myself and Mrs Cannell badgered the Minister; it is our duty to do that, both in the House and outside the House, but proper, honest answers were not forthcoming. Perhaps the Minister has learned a lesson from that. How many more lessons does the Minister need to learn when he realises that he is dealing with very determined people, who will not give up?

Then we asked for the Minister to provide us with the Holcombe Report and they would not do 5805 that: they would not let us have it, because the Holcombe Report was, as has been set out this evening so eloquently by Mrs Cannell, that there were areas and elements of criticism in it, where the service on the Isle of Man is ‘fractured’. That was the quotation of it and so that was denied us. Mrs Cannell had the initiative to contact Christopher Holcombe, who e-mailed it to her. The Department really fell, they really fell from grace when they realised that the Holcombe Report 5810 was circulating interested parties in the Isle of Man.

The Department has played down the information and the advice that has come back from the President of the Association of Breast Surgeons, Richard Rainsbury, who stands by his word and knows what he is talking about, but they set out to water that down, of course, during the presentation today – the presentation, that was so late in the day, that Members of this Hon. Court 5815 were concerned about, but now they have been reassured. Richard Rainsbury, do not forget, congratulated the high quality of service we already have here in this Island and being fortunate for securing, at the locum basis, a high-quality surgeon.

Mr President, the Hon. Minister, when he put forward his comprehensive response today, about the Hon. Member Mrs Cannell’s motion was flawed and we had this eleventh-hour 5820

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presentation with all his Department’s big guns to deal with that, I asked a question at that. For those who attended, I asked a question. Members will remember me asking this question. We have got all the qualified people, plus the back-up people, who were there to answer all the questions, but there was somebody else who was missing: the person they employ as a locum. Why did they not bring her along for her to finish off reassuring us all that all is bright and beautiful. Why was 5825 she not invited to come? The answer I have got –

Mr Anderson: Point of order, Mr President. He was told the answer to that in the presentation. 5830 The President: Yes. Mr Houghton: I am just getting to that. The answer to that was given, it was watered down

and it was not acceptable, Minister. Yes, of course, I was given an answer to that. But it was quite obvious: if you have got a specialist… Here is a locum. Here, as a locum, they were so worried, 5835 they brought… and they have taken time – valuable medical time now, of Mr Upsdell’s time – this evening to sit through this debate, listening to all of this. He cannot advise – unless he can, of course, sending you information sheets across to members from the Department, which he may or may not have done. We have wasted a lot of his time and I apologise, not just to him for that, but I apologise to the Island for that because patients need his care – not him sitting in here, listening to 5840 all this.

But I home in on this point: if the Department is so convincing, ask yourself why did they not bring the locum consultant surgeon, to tell us all was bright and beautiful? I am sure, if that lady – who I have never met or spoken to – had been brought to the briefing and sung that hymn to us all, that Mrs Cannell would have been quite happy to withdraw it; but that lady was nowhere to be 5845 seen. Of the Department’s huge and comprehensive pack of information that we have got, there is nothing there… There is a lot about Miss Hamo’s movements, statistically – nothing from Miss Hamo. I would have loved to have seen a foreword from Miss Hamo to say all is bright and beautiful. So I am not sure whether all is bright and beautiful or not.

Turning, Mr President, to the objectivity of all this and the playing around, of course, with 5850 politicians, in what they have to say and the reassurance they are given with these two amendments that are before us. If you read the Hon. Minister’s amendment – and I shall read it out, just so that we can all really understand it – it says, if it is amended:

‘That Tynwald supports the Department of Health ensuring that the Breast Care Service is maintained and enhanced to 5855 ensure that there is no diminution in the present level of service provided within the Island, and supports the Department continuing to provide a dedicated breast care service led by a surgeon specialising in breast surgery, thereby securing the service provided to patients.’ Well, if they are providing that on the eleventh hour, if everybody believes that – and all credit 5860

to the Member for Malew and Santon for backing that up – to have a watch committee by this parliament, to watch that the Department does that… why are we here? I tell you why I am here on all of this: it is because I care. I care, like I hope every other Member of this Court – sometimes I wonder whether they do; they care about themselves. But I care about what is going on here, because I see far too many prevarications by the Department. I see an unprofessional approach, 5865 and so it worries me and concerns me. That is why I back Mrs Cannell to the hilt. That is why.

Now, Mr President, the watch committee, which follows anything – as the Hon. Member, Mr Cregeen has already stated – his amendment can be added to the one that I know everybody will support tonight, the Department amendment, or the one that is on the Order Paper by Mrs Cannell. A watch committee: most speakers speaking after the Hon. Member, Mr Cregeen, put that down, 5870 mentioned – including the Chief Minister – that they support the watch committee. That is what I would call them; that is what they are there for – a parliamentary watch committee.

Now, I ask this Hon. Court if they would put a doubt in their mind as to why Miss Hamo was not brought this afternoon to reassure us. Other Hon. Members in this Court also must have a doubt. That is the reason why they appear to be supporting the watch committee. So there is a 5875 black mark on that Department, no matter what they say.

No matter how you dress it up, Mr President, the watch committee is there because there is a degree of distrust in what is going on here.

Thank you, sir. 5880 The President: Mrs Cannell to reply.

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Mrs Cannell: Thank you, Mr President. It has been a fairly predictable debate, as far as I am concerned, because I knew that I would be

faced with the opposition from the male Members of the Court that I have faced. 5885 A Member: Shame. Mrs Christian: And a woman. 5890 Mrs Cannell: It is a shame, an absolute shame. Mr Teare: It is shameful making that comment. Mrs Cannell: The Minister was first upon his feet moving his amendment and he said that my 5895

motion was flawed and he went… What I am not going to do, Mr President, I am not going to respond to the personal abuse and

criticism that I, as an individual, have received on behalf of raising this issue in Tynwald Court, save to say that I have not led this campaign; I have assisted it from the rear. (Mr Houghton: Hear, hear.) The people have led this campaign. (Mr Houghton: Hear, hear.) Why they did not go 5900 to another Member of Tynwald, I do not know, but they came to me and I took an interest.

So that is the first point and how dare any Member of this Court accuse me of otherwise! (Mr Henderson: Hear, hear.) I do not need to use issues like this as an election platform. If there is a consequence of doing it, I lose my seat, because I have spent so much time and dedication and commitment to this, then I am philosophical about that. If my people are upset because they did 5905 not get a call to me at canvassing time, because I have been too busy with this, then so be it. I accept that, (Mr Houghton: Hear, hear.) because I feel it was my duty to bring the people’s concern with regard to the breast care service to this Court, because there was a policy change underfoot. At least the Chief Minister had the dignity and respect of Tynwald Court to say that he felt it was the appropriate place to be discussing this issue. It is a policy change. 5910

So I am not going to respond to the personal criticisms. What I would say is that the petition has been… There is a lot of criticism. I am not going to respond to any of the criticism, because that is all very negative and what I was hoping for was that we would have some very positive debate on this very important issue.

What I would say, though, with the Minister’s opening remarks is that he said that breast 5915 surgery is part of general surgery; it is not recognised as a sub-specialty. Well, he ought to know, because I have reminded him on several occasions, that the Association of Breast Surgeons (ABS) have applied to the General Medical Council for breast surgery to be acknowledged as a sub-specialty in its own right. I am reliably informed by the ABS and the British Association of Surgical Oncology (BASO), that it is likely to receive approval by mid-next year. I am looking not 5920 just now, Hon. Members, but now and into the future. I will not say any more on that point from the Minister at this juncture.

The Bishop said very little, other than he knows about it and he is supporting the amendment. Then Mr Cregeen moved the amendment for it to be referred to the Social Scrutiny Committee,

as and when it is appointed after the General Election on 29th September. I think the one thing we 5925 want to remember here is that the job advertisement is advertising for a 40-hour-week post. It is a 40-hours-a-week post. The sentinel node biopsy and breast reconstruction, if it is to be rolled out, will be totally reliant on there being additional hours worked by the new person coming in, because if it is not possible to do those two procedures now, with a surgeon who is working 44, on average, hours a week, then it is not possible for someone else coming in, working four fewer 5930 hours a week, to be able to roll out that new service. So I think it is a sort of carrot and a stick. The Department shows the carrot to get everybody to bite, but then uses the stick, to put them back into the position that we were two years ago.

It is interesting to note that, in the new job description which was supplied to Members at lunchtime, there is no mention at all about sentinel node biopsy. It does not feature at all. 5935

Of course, in addition to all of that, Mr Cregeen, in talking about his job advertisement for the 40-hour week – none of that takes into consideration any private work the individual might want to undertake. There seems to be this perception within the Department that whoever comes in, they are limited to advertising for 40 because that is the rules and regulations with the Royal College of Surgeons – okay, that is accepted – but they seem to consider that anybody coming in for this new 5940 role will want to do those extra hours and will want to do the general on-call surgery because it gives them more money.

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So they are after the money. It begs the question what is safe for the patient? Do we want surgeons operating 60, 70 or 75 hours a week? These are the sorts of things that came up at the public meeting and they were not adequately addressed by those who were on the panel 5945 representing the Department.

Mr Speaker: I thank him for his comments. He at least, I knew, would understand the subject matter and he did. I thank him for that and for appreciating the actual concerns raised by the breast cancer patients.

Mr Gill said he supports the amendments. He is disappointed that the Department has not 5950 managed to speak with myself and my colleague, Mr Houghton, my friend, in the early days, so that we could get this resolved. I am disappointed that did not happen, too, but I was faced with no choice today. I had to raise it, because we had not got anywhere, in terms of being able to get round the table and meet.

The Hon. Member for Onchan, Mr Earnshaw: oof! Very disappointing – quite alarming, really. 5955 I imagine he is going to get a tough time when he goes out canvassing in Onchan with the comments he has made: pressure groups should not be running Noble’s Hospital; I have led the campaign –

Mr Henderson: Egged it on. 5960 Mrs Cannell: – egged it on; led by Mrs Cannell. That is why I wish to clarify it right from the

start: I have not. I have not, but I am prepared to take the knocks, because that is the nature of the job, isn’t it?

(Mr Houghton: Hear, hear.) I will be the whipping girl, if you like, for the better good, for the 5965 people in the Isle of Man. I will take that and I do not mind taking that. (Mr Houghton: Hear, hear.) But I refuse to be criticised by those who themselves have perhaps been subject to something similar in the not-too-distant past, before they were spoiled by the Council of Ministers’ carrot.

Can I say, you say pressure groups should not be running Noble’s Hospital: no, they should not 5970 – but the Department should be mindful of public opinion. (Mr Henderson and Mr Houghton: Hear, hear.) Look what happened the last time a Health Minister got up and ignored public opinion, regarding the relocation and the rebuilding of Noble’s Hospital. Over 10,000 signed that petition. I appealed at the Bar of Tynwald. (Interjection by Mr Anderson) I am on my feet, Minister – my turn! My turn. 5975

I appeared at the Bar of Tynwald. My hon. friend and colleague for North Douglas, Mr Henderson, before he was involved in politics, attended at the Bar of Tynwald, as did a number of others. Tynwald backed their buddy, the Minister, and it is likely to happen today. I knew that before I walked in here today. (Mr Houghton: Hear, hear.) You can predict what the vote is going to be. The Hon. Member for Onchan is right, it is ‘clubby-clubby, buddy-buddy’. If I wore trousers 5980 and a suit and had a gruff voice and was a man, I would probably get more co-operation from you from time to time, but I do not. (Interjections)

The Chief Minister: Point of order, Mr President I am sorry, Mr President, there has to be some respect for Members. 5985 Several Members: Absolutely. Hear, hear. The President: Okay, point is taken. Mrs Cannell. 5990 Mrs Cannell: Yes, I will show the same respect that they have shown me, throughout this

entire debate. (Mr Houghton and Mr Henderson: Hear, hear.) (Interjections) What I was going to say is that there was public concern, public pressure, the last time and that

particular Health Minister lost his seat. 5995 The Hon. Member for South Douglas, Mr Malarkey, said – and he is correct – that the locum,

when she came in two years ago, got a huge waiting list down. We cannot afford to have waiting lists, when breast cancer is an issue. You cannot afford to have huge waiting lists like this. If it is non-symptomatic, that is fine, but there is a great deal of work goes into assessing whether or not it is symptomatic disease – in other words, cancer – and to what degree it is, where it is, what it is, 6000 and the extent of treatment and/or surgery that is required. That is a lot of work involved in just doing that with one patient. You cannot afford to have people waiting to be seen again. So it is down and it needs to stay down. (Mr Houghton: Hear, hear.)

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I have not got his confidence quite so much, though, in that, because promises have been made by this Minister for Health, in Hansard, that they will be honoured by the Department. Having 6005 chaired the Scrutiny Committee – the only Scrutiny Committee at the moment – of Tynwald, one of our responsibilities is looking at the Policy Decisions Report produced by Government every year, in terms of their update on the policies and decisions adopted by this Hon. Court. I have to say, we struggle from time to time, in terms of trying to get it through to the relevant Department that the interpretation of the motion and the intention of the parliament is different from how they 6010 perceive it. We struggle, trying to get your policy decisions into action with Departments, because of the degree of perception problem, and the wording. So I do not quite have that.

Minister Quayle moaned about the petition, inaccurate information pack; he said the Tynwald Policy Decisions Report, blah, blah… Scrutiny Committee… Yes, it is, but we will not be in being, once this House dissolves and Tynwald Court has its last session. There will be no more 6015 Tynwald Policy Decisions Report considered by a Scrutiny Committee of Tynwald, as it is now. We will have three standing Scrutiny Committees, and they sometimes might oversee similar policy matters or legislation. So we do not know how it is going to be formed; we do not know what the format is going to be. We certainly have no idea who the membership is going to be, because we have to wait until after the General Election. 6020

Mr Corkish: I am glad that he actually declared that he is involved with a cancer charity, and I think a lot of Members who got to their feet today are actively involved with a cancer charity. Now, why the charities have fallen out, and it has got a little bit nasty, with individuals getting nasty with each other, I do not know why that is. I do not know why the charities see the action group as a perceived threat – 6025

Mr Earnshaw: I don’t think he was saying that… Mrs Cannell: – but what I would say is that the action group is made up of former members of

both Isle of Man Breakthrough and Isle of Man Breast Care. 6030 Mr Houghton: That tells you something. Mrs Cannell: They broke away from those two organisations to form the action group,

because charities are apolitical. (Mr Houghton: Hear, hear.) They are apolitical. Their whole 6035 intention is to raise funds, awareness, help people and they need to work closely with Government, because they need to be able to influence the Health Department in terms of what they want for the people in their charity and also, from time to time, might ask for contributions towards certain initiatives that the charity wants to do. So it is important that they keep good working relationships. So you cannot expect a breast cancer charity or two to take on Government and start 6040 opposing what it is that they are trying to do, when it is perceived as being a downgrade of a current service, can you?

So having the support of the charities… The charities would do nothing other than support the Department. They are totally reliant upon the Department’s goodwill and working relationships.

6045 Mr Anderson: The other way round. Mrs Cannell: It is not. (Mr Earnshaw: Partnership.) It is not. Goodwill and good working

relationships are absolutely crucial, (Interjection by Mr Houghton) if a charity such as a cancer charity is going to continue to function, in respect of its own interest in that type of cancer. 6050

The breast screening and recall service… I think the one thing, perhaps, I did not make clear at the onset: the breast screening and recall service calls women aged between the ages of 50 and 70. We are getting more and more women under the age of 50 who are developing symptomatic breast disease. Why is that happening? We do not know. How do they get to see the current surgeon? They are referred through their GP. The referral rate is pretty high, at the moment. These are ladies 6055 not being picked up by the breast screening or recall, and for the Department to totally focus their strategic development of this service just on that, I think is very foolish, and also very risky and could potentially put breast cancer patients at risk sometime in the future, unless the service is closely monitored.

The information we got from the Department at lunchtime, when it gave the numbers of those 6060 patients diagnosed from January to June, being 26: six of those were detected after having a mammogram. They were screen detected. Twenty were detected through symptom detected… So that gives you an idea of it. Not all of these cases that are coming up are as a result of the mammogram service – the screening and recall service.

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That is the one thing that we should be very mindful of. There are more and more young 6065 women who are being diagnosed. That is why I have taken this issue so seriously, to be honest, because I have been quite alarmed at the amount of younger women with this problem.

Mr Corkish also went on to say, in an ideal world we would all live by and put in place Mr Rainsbury’s opinion. I think it is an absolute disgrace to talk about the President of the Association of Breast Surgery in such a demeaning way. I think we have to have due regard to such experts. 6070 He is the expert. He is the expert. (Interjection by Mr Corkish) He was going on about what he was describing, and he was also saying that it was not the locum consultant surgeon who is in post currently who is responsible for the improvements; that those improvements were put in place before she came. I would ask the Hon. Member to re-read Mr Rainsbury’s opinion, because I do not think he has understood it correctly. 6075

Mr Karran raises a good point: how can 100% resulting in 80%… be not a downgrade? We still have not had an answer to that.

Mr Butt: the one thing I would take issue with him is that he talked about the present consultant being registered as a general surgeon with an interest in breast. I would ask him, as Member for Health, tonight, if he feels as though he is capable, to log on to the General Medical 6080 Council website and put in the name of the consultant locum breast care surgeon. All it will ask you is ‘Is it a male or female?’ You click on female, and all her particulars and qualifications will come up on screen.

You can then ask for more information and that site will tell you that she is on the specialist register, and that she has only concentrated on breast surgery – only, with no general surgery – 6085 since 2008: just pure breast surgery since 2008.

The Chief Minister – I acknowledged him before – said it is the right place for the policy debate. But obviously he is going to support his Health Minister – as they always do. They always rally round together. (The Chief Minister: Matey-matey.) (Laughter)

Again, the Hon. Minister, speaking to the amendment moved by the Hon. Member, Mr 6090 Cregeen, with regard to the question of surgeons may not agree to more hours: that is a huge possibility, because the actual job description and application specifies 40 hours a week. It specifies two theatre sessions of three hours – not four, Mr Butt, but three – and it specifies three clinics a week. Now, if any of the new enhancements are going to be rolled out, or any private work is going to be undertaken, that is going to have to be accommodated by doing extra hours. 6095 There is no compulsion within the job description to actually agree to that. So you could, in fact, as Mr Cregeen said, get somebody applying who satisfies all of the criteria laid down in the revised job description, because the area, where they want to roll out and enhance is all subject to negotiation after the post-holder has been recruited and is in place.

That person could say, ‘Well, I am not interested in this. I just want to specialise in what I’m 6100 doing.’

Before I finish, Mr President, I would just like to thank the Minister for circulating some of the letters from a retired oncologist, a retired radiologist and a retired general surgeon. My experts at least are all in practice still. (Interjections and laughter)

The letter from Mr Clague to the Minister is dated 16th May 2011. I think there is one very 6105 pertinent paragraph towards the end: it is the second to last.

Mr Anderson: Go on, read it all. Mrs Cannell: You should have read these before coming here, Minister. 6110 ‘The post as envisaged is not really one that most applicants would identify as being a general surgeon with an interest in breast care, as it has a relatively small elective general surgical component but a significant on-call commitment. It is also not a dedicated breast surgeon, with no general surgical commitment. How many candidates there are out there that will find such a post attractive and how happy a successful applicant would see themselves in the long term 6115 remains to be seen.’

(Mr Houghton: Hear, hear.) Now, to me, that is key. So he is obviously very aware of the awkward position that the poor gentleman finds himself in: he has a visit from me, then he has a visit from the Minister, and then he has a visit from the Minister’s experts in the Hospital. But he 6120 still corresponded with me and I am pleased that he put that into the latter to the Minister, because he is still saying there is a doubt that, in fact, we will be able to get this individual, and whether or not we would keep them, because of the limitations.

I had an e-mail from the President of Isle of Man Breakthrough: 6125

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‘Thank you for all the research you are undertaking on this very important topic. We are all aiming for the very best breast care service here on the Island and will not be happy with anything that is second best or a downgrade, which is totally unacceptable.’

(Interjections) But she did not accuse me of scaremongering or whipping it up into a frenzy. She 6130 said, ‘Thank you for all the research you are undertaking.’

So do not let the Department, Hon. Members, think that it is all on its side, because it is not. It is not.

Just to finish, I will quote again from the business case which the Minister has not circulated to Hon. Members, but I did. ‘Breast care service activity’ – this is for the year up to August 2010: 6135

‘The current referral rate to the breast care team is around 24 new patients per week. These are seen in the symptomatic clinic, with follow-up patients, and this may involve up to 38 patients in a morning clinic. Breast screening recall patients are also being seen in the afternoon – up to 10 patients. The histology review clinic usually sees four to 12 patients.’ 6140 That is quite a large caseload. Outpatient attendances from 1st April 2009 to 31st March 2010

were 2,255 attendances. Just in April and May – two months – in 2010 last year, there were 377 patient attendances. It is those figures that were supplied by the Department in their business case that were submitted to the President of the Association of Breast Surgery. Nothing more – no 6145 skewed figures: those were the figures quoted.

Mr President, I obviously will not be supporting either amendment, because I have to stick purely and simply with the motion on the agenda, because I think that is the best way forward.

The Department’s amendment is curious, in that it does not acknowledge any of the general surgery, on-call commitment of going for a new person for this post. It just says that Tynwald: 6150

‘supports the Department of Health ensuring that the breast care service is maintained’

- maintained as one, maintained as it is – 6155 ‘and enhanced’

- that is your sentinel node biopsy and your breast reconstruction – ‘to ensure that there is no diminution in the present level…’ 6160 How can it be enhanced to ensure that there is no diminution in the present level of service?

The present level of service is just simple surgery, because the present incumbent is not allowed to practice her expertise here. So that is why I think it is a little curious. They talk about ‘enhanced’; it cannot be enhanced, if they are literally going to keep it at its present level. 6165

‘… and supports the Department continuing to provide a dedicated breast care service led by a surgeon specialising in breast surgery, thereby securing the service provided to patients.’ Well, of course, that is where they get away with it, is it not, Mr President? ‘A dedicated breast 6170

care service led by a surgeon’ – a surgeon. So they have dropped the generality of it but, in fact, they are after one of the same.

So, all this amendment is, really, is playing with words, (Mr Houghton: Hear, hear.) but it is to try and bring you back on course with what they have desired all along, so I would ask the Court to reject it. 6175

Thank you, Mr President. The President: Hon. Members, we have reached the time when you make your decision on

Item 49 on the Tynwald Order Paper. Hon. Members, the motion I put, therefore, is that printed on the Order Paper and to that you 6180

have the two amendments: the amendment in the name of Mr Anderson and the amendment in the name of Mr Cregeen. I propose, Hon. Members, to put them in that order.

So, first, I will put to you the amendment in the name of Mr Anderson. Hon. Members, those in favour of the amendment, please say aye; against, no. The ayes have it.

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A division was called for and electronic voting resulted as follows:

In the Keys – Ayes 16, Noes 5

FOR AGAINST Mr Quirk Mr Karran Mr Earnshaw Mr Houghton Mr Brown Mr Henderson Mr Crookall Mrs Cannell Mr Anderson The Speaker Mr Bell Mr Quayle Mr Teare Mr Cregeen Mr Malarkey Mr Robertshaw Mr Corkish Mr Shimmin Mr Cretney Mr Gawne Mr Gill

The Speaker: Mr President, in the Keys 16 for, 5 against. 6185

In the Council – Ayes 9, Noes 0

FOR AGAINST Mr Callister None Mr Crowe Mr Downie Mrs Christian The Lord Bishop Mr Lowey Mr Butt Mr Turner Mr Braidwood

The President: In the Council, Hon. Members, 9 for, none against. The amendment therefore

carries, Hon. Members. I put to you, now, the amendment in the name of the Hon. Member for Malew and Santon, Mr

Cregeen, which will build onto that amended motion. Hon. Members, those in favour of Mr Cregeen’s amendment, please say aye; against, no. The 6190

ayes have it. A division was called for and electronic voting resulted as follows:


FOR AGAINST Mr Quirk Mr Henderson Mr Earnshaw Mr Karran Mr Brown Mr Crookall Mr Anderson Mr Bell Mr Quayle Mr Teare Mr Cregeen Mr Houghton Mr Malarkey Mr Robertshaw Mrs Cannell Mr Corkish Mr Shimmin Mr Cretney Mr Gawne Mr Gill The Speaker

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The Speaker: Mr President, 20 votes for, 1 against.



The President: In the Council, Hon. Members, 9 for, none against. Hon. Members, both amendments having carried, they will replace the motion on the Order

Paper in that order – Mr Anderson’s and Mr Cregeen’s building upon it. 6195 So I put to you Item 49, as amended. Hon. Members, those in favour, please say aye; against,

no. The ayes have it. A division was called for and electronic voting resulted as follows:


FOR AGAINST Mr Quirk Mr Karran Mr Earnshaw Mr Houghton Mr Brown Mr Henderson Mr Crookall Mrs Cannell Mr Anderson Mr Bell Mr Quayle Mr Teare Mr Cregeen Mr Malarkey Mr Robertshaw Mr Corkish Mr Shimmin Mr Cretney Mr Gawne Mr Gill The Speaker

The Speaker: Mr President, 17 votes for, 4 against.



The President: In the Council, Hon. Members, 9 for, none against. The amended motion

therefore carries. 6200

6363

17th September 2014 Evidence of

Hon. R H Quayle MHK, Minister; Mr

M Charters, Chief Executive Officer;

and Mrs M Morris, Executive

Director for Health, Department of

Health and Social Care

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Published by the Office of the Clerk of Tynwald, Legislative Buildings,

Finch Road, Douglas, Isle of Man, IM1 3PW. © High Court of Tynwald, 2014

S T A N D I N G C O M M I T T E E

O F

T Y N W A L D C O U R T

O F F I C I A L R E P O R T

R E C O R T Y S O I K O I L

B I N G V E A Y N T I N V A A L

P R O C E E D I N G S

D A A L T Y N


DEPARTMENT OF HEALTH AND SOCIAL CARE

HANSARD

Douglas, Wednesday, 17th September 2014

PP2014/0120 SAPRC-HSC, No. 1/2013-14

All published Official Reports can be found on the Tynwald website www.tynwald.org.im/Official Papers/Hansards/Please select a year:

6767

STANDING COMMITTEE, WEDNESDAY, 17th SEPTEMBER 2014

__________________________________________________________________ 2 SAPRC-HSC/2013-14

Members Present:

Chairman: Mrs B J Cannell MHK Hon. S C Rodan SHK Mr E A Crowe MLC

Clerk:

Mr J D C King

Contents Procedural ........................................................................................................................................ 3

EVIDENCE OF Hon. R H Quayle MHK, Minister; Mr M Charters, Chief Executive Officer; and Mrs M Morris, Executive Director for Health, Department of Health and Social Care ................... 3

The Committee adjourned at 4.58 p.m. ......................................................................................... 39

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Social Affairs Policy Review Committee

Department of Health and Social Care

The Committee sat in public at 2.30 p.m. in the Legislative Council Chamber,

Legislative Buildings, Douglas

[MRS CANNELL in the Chair]

Procedural

The Caairliagh (Mrs Cannell): Welcome to this public meeting of the Social Affairs Policy Review Committee which is a Standing Committee of Tynwald Court.

I am Mrs Brenda Cannell, a Member of the House of Keys, and I chair this meeting. With me is the Hon. Steve Rodan, Speaker of the House of Keys, and Mr Alan Crowe, who is a Member of the Legislative Council. To my right is Mr Jonathan King, who clerks this Committee. 5

Please ensure that your mobile phone is switched off and not just on silent as it interferes with Hansard. Also for the purposes of Hansard, I will be ensuring that we do not have two people speaking at once, which at times can be quite difficult when you have three members sitting on a panel.

The Social Affairs Policy Review Committee is one of three Standing Committees of Tynwald 10

Court established in October 2011. We have a wide scrutiny remit. We have three Departments to cover, namely Education and Children, Health and Social Care and Home Affairs. Our last general oral evidence session with the Department of Health was January 2013 and our last general oral evidence session with the Department of Social Care was in July 2013. This will be our first general oral evidence session with the newly-created Department of Health and Social 15

Care, which was established in April this year. Before we begin I would just like to say to the witnesses that we have quite a long list of

topics to cover today – in fact a very long list of topics to cover because for us it is like having two Departments in one session. If we do not get to the end of our questions today, we may invite you to come back and continue at a mutually convenient time. 20

EVIDENCE OF Hon. R H Quayle MHK, Minister;

Mr M Charters, Chief Executive Officer; and Mrs M Morris, Executive Director for Health,

Department of Health and Social Care

Q1. The Caairliagh: I would like to start by welcoming our witnesses and asking each, starting with the Minister, to state their name, their job title and when they took up their position.

The Minister for Health and Social Care (Mr Quayle): Okay. Thank you very much, Madam

Chairman. 25

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My name is Howard Quayle. I am the Minister for Health and Social Care and I was appointed at the beginning of March 2014.

To my left is Mrs Michaela Morris and she is our new Executive Director for Health. Michaela started at the beginning of September, of this month.

To my right is Mr Mark Charters, the new Chief Executive Officer of the Department and he 30

has been our new chairman for all but two months. Mr Charters: Week 11. The Minister: Week 11. 35

Q2. The Caairliagh: Week 11… early days. Thank you, Minister. If I could start then with Mr Charters, and other than what the Minister has just introduced

you, could I ask you what qualifications and experience you bring to this new post? 40

Mr Charters: My background is in social care, initially in children’s social care. I then trained as a social worker and then into social care, senior social work, across both children and adult services. Then working in a number of health settings, including the John Radcliffe Hospital in Oxford, where I ran social work, the in-patient social work services, and then into management in various locations across the UK, including Newbury, where I was service manager for older 45

people. Then down to Southampton where I was an assistant director for social care working with the Primary Care Trust and the City Council.

I then moved to my director position for Northamptonshire County Council, heading up adult social care, the Council's cultural services, again working very closely with the three Primary Care Trusts, the community health care services. 50

Prior to taking up the post prior to this one, I have worked for the London Borough of Bexley for seven years, initially as director for community services, again adult social care, the Council’s housing allocations services, and then for the last three years headed up and merged a department that included adult social care and children’s social care, working again very closely with Primary Health Care in developing integrated pathways across both children and adults and 55

with the acute hospitals provided for South East London. Q3. The Caairliagh: Okay. In respect of the health services side of it then, you said that you spent time at John Radcliffe

Hospital and then latterly you named a couple of others. In what sort of capacity were you 60

gainfully employed there? Mr Charters: For John Radcliffe, I headed up a division of social care, in-patient social care

social workers that were responsible for working across wards and designated wards to help with discharge planning to help with the process of discharge and resettling and establishing 65

care plans in the community for clients exiting the John Radcliffe Hospital. In Bexley, clearly as a strategic manager, I was involved working with chief executives and

directors of both the hospital and Primary Care Trusts to look at developing a strategy for health and social care that enabled integrated pathways in and out of hospital, but with a key focus on preventing admission and promoting discharge, reducing needs as far as possible and enabling 70

as much needs to be met in a community or a home, as opposed to institutional based settings. Q4. The Caairliagh: Okay. Thank you very much for that. If I could then ask Mrs Morris the same question, please, what qualifications and experience

do you bring this new role? 75

Mrs Morris: Thank you, Madam Chair.

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I have had 28 years of experience in the UK NHS. I started my training as a nurse in 1984. I am a qualified nurse and then went on to do a qualification in midwifery. So I had the first 10 years of my time in the NHS as a pure clinician and majored in maternity and midwifery care at that 80

time. I worked in the hospital and community settings as a clinician. From the mid-1990s, I took up management posts, most of which had clinical roles attached

with them as well I had my first director's post in the UK NHS in 2005. I was a director of operations at Ashford and St Peter’s Hospital in Surrey, a multi-site hospital just straddling the M25 – quite a busy area. I had a second post there, which was a combined post of director of 85

operations and director of nursing at Ashford and St Peter’s. I went on then to my next role, which was chief operating officer at Newham Hospital in the

East End of London. I was in that role for a year and a month before I took up the post of chief executive for that organisation, which I continued in until just before the hospital merged with Barts, The London and Whipps Cross, and so it has now become the biggest Trust in the UK. 90

I left the NHS at that point. I did not go for a position in the new Trust because it was one of those very, very large organisations, which I decided was not going to suit the way I like to work. So I took the opportunity to work with Lord Ara Darzi, who previously was a Minister in the UK Health Service. He continues to practise in the UK, but he has also a small group of consultants who were working with him on a project in the Middle East. So I have been in the Middle East in 95

Qatar for the last three years… well, two and a half years, where I was embedded at the time in the Primary Health Care Corporation. For a year of that time, I was the director of operations for the Qatar Primary Health Care Corporation. During the time, they were recruiting to a local national to take up the post. I decided to return closer to home again and literally have been appointed since the middle of the summer here. I started in post on 1st September. 100

Q5. The Caairliagh: Okay. Thank you very much. Mr Charters, you come from very much a social services background, as you explained at the

beginning. Can we ask what experience you have of managing health services? 105

Mr Charters: A key principle of social work is looking at the whole person and looking at a client-centered whole person approach. Invariably, both as a practitioner and subsequently as a middle and senior strategic manager, my job has been about working with colleagues around the whole person and including the communities in which the whole person and families live. For me it has been about experience with colleagues and health professionals at how we put 110

together strategies, approaches, plans and thinking that deals with the whole point in an integrated way that enables us to move. I have put strategies in place that have played and been successful in working across social care, health care and clinical care to look at meeting needs across the board of both health and social care.

Inevitably as we move forward in an integrated way, of course we need specialist skills and 115

specialist clinical and social professional knowledge and practitioners to discharge that, but equally at a strategic level we need people that can put that whole picture together and that is something I think I have some breadth of experience and success in and clearly want to try and do the same for the Isle of Man residents.

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Q6. The Caairliagh: Before I invite Mr Speaker to ask a further question on that, what you are saying is very laudable treating the whole person, but it does not really answer the question for us in terms of what experience you have in managing health services. (Mr Charters: Yes.)

You manage the outcome for the person, the whole of the outcome for the person, but it is really from the position of being able to manage those who work in the hospital or the clinicians, 125

the surgeons in particular, and the staff, so that you are going to get the same level of co-operation that perhaps you have experienced elsewhere. What experience have you got to be able to deliver that, for example?

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Mr Charters: Well, Madam Chair, I am not here to be a doctor. I am not employed to be a clinician. I have been asked to come to the Isle of Man to help lead the strategy and vision for 130

health and social care across the Isle of Man. I will add my qualities and I am not suggesting and have not suggested for one moment that that is first-hand experience in managing clinicians or having that expertise. Michaela Morris has that expertise and is part of the leadership team that will take health and social care forward and make the improvements that are very clearly needed. I have an offer in that and that is what I have been and the Minister has recruited me to 135

discharge those responsibilities. It is not going to be being able to show a breadth of experience of managing doctors or clinical services.

I have, however, worked and would point to my time in in the John Radcliffe Hospital working and setting up multidisciplinary arrangements with consultants, with clinical experts and multidisciplinary teams. Clearly that has given me an experience of working with and making it 140

work as a whole system. In Southampton I worked with the Primary Care Trust and indeed in Bexley with clinicians

that are part of that, the GPs, community and district nurses, and so part of the teams that I was responsible for included those medical services. So I have had experience of managing, but I would not… no, I would not say that that is my area of expertise. 145

Q7. The Caairliagh: So you have not been brought in to actually manage our expectation, if

you like, to bring this all together? The Minister: Could I come in on that one, Madam – 150

Q8. The Caairliagh: You have been brought in for strategy development. No, I will invite you, Minister, a little bit later (The Minister: Right.) because I think

Mr Speaker has got a question based on the response we have had from Mr Charters. 155

The Speaker: Do you want me to come in there? The Caairliagh: Okay. Yes. Q9. The Speaker: Good afternoon, Mr Charters. Welcome to the Isle of Man. (Mr Charters: 160

Thank you.) What you have described is your background and experience of delivering policies which

have joined-up health care and social care. You would agree with me that the policies, in a general sense, that Government implements are all the product of statute law – primary legislation and secondary legislation. I just wondered, with your local authority background, 165

what experience you had of specifically working with primary legislation that underpins the policies, as opposed to local authority guidance with which you might be more familiar?

Mr Charters: Indeed. Could I just take a step back in answering that question because I think policies and indeed 170

law is shaped by a clear understanding of an individual and collective need and so I think the source of that string, if you like, is understanding what is an effective outcome for our users, our customers, in this case the residents of the Isle of Man.

How should Health and Social Care be delivering its services? What are the outcomes we should be delivering? What are the needs that we… and how well we could be delivering those 175

things? How is our current legislation and our policies and the strategies that are formed to help deliver that, how can they be improved?

One of the things that I want to be doing is working on looking at our legislative arrangements and making sure that we have the tools within them to drive the improvements that are needed across Health and Social Care and where they are not working, and I fully 180

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recognise the need for us to have the legal framework in which to be able to make the improvements and discharge services… so where we have not got that framework, to start putting legislative arrangements in place that enable us to have those powers and discharge those responsibilities.

But it is not… I would not say I would see legislation as the start of that journey. I think the 185

start of that journey is having a very clear idea of what our needs are and how well we are currently serving them or not and what improvements then are needed to get us to that point.

Q10. The Speaker: But you would accept that all policy is derived from the legislation and the

ability to implement the policy? 190

Tynwald legislation, primary and secondary, of course is quite different… similar, but quite different from the UK Children's Act, for example. (Mr Charters: Indeed.) Would you anticipate bringing new Orders to Tynwald fairly soon in order for you to implement the policy you would like to?

195

Mr Charters: As I mentioned at the outset, this is week 11 for me. I have a job to do in terms of bringing together an effective leadership team for this service. I have started by setting out some initial high-level thinking in relation to a vision and objectives within the leadership blueprint for Health and Social Care and that is now part of the recruitment arrangements that I am going through in order to establish that leadership team. 200

Once we get… you know in many ways it is like a line of dominoes: you cannot drive an effective vehicle until you have built your vehicle to drive in. I have not got to that point yet. I am building and when we get to the point where we have that leadership team we will be employing a range of strategies that will be analysing our current arrangements that will be looking and feeding from information that we are getting from the West Midlands, other 205

scrutiny, other feedback, and not least our customers and the people who use our services, putting together how fit are we currently, where aren’t we and where is the improvement needed. Then that will include how does legislation currently work to enable that, where there are deficits and where do we need to increase and improve and change those arrangements.

So, no, I am not in the position yet of being able to say to you what the new development in 210

our legislation is going to be, but I will be when we get to that point. The Speaker: Thank you, Chair. I will come back to that in the context of social services later,

if I may. 215

The Caairliagh: You have a question? Mr Crowe: No, not at the minute, thank you. Q11. The Caairliagh: Right, the way I am going to manage the great list of questions that we 220

have is to split it in terms of health service management, health services delivery, social care, social security, and of course, very importantly, we have got questions on housing and I have also got some questions for the Minister specifically.

But, if we can just briefly go through the health services management, we have been studying the Beamans Report and had another look at it on Monday and the action plan which was 225

submitted to our Committee by Mr Colin Kniveton on 16th June 2014. The Beamans Report recommends the job of hospital managing director, but Mrs Morris has been appointed Managing Director for Acute Services and we are a little bit confused. Is this the same thing, Minister?

230

The Minister: Yes.

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The Caairliagh: It is. So the pie chart – 235

The Minister: If I can hand over to Mark who is – Q12. The Caairliagh: Well, before you do, Minister, the pie chart which is illustrated in the

Beamans Report, what we have or the structure you are currently putting in then differs from that, does it? 240

The Minister: It does indeed. I think if you look at the… I think we have given you evidence on

the blueprint for the Department going forward. Q13. The Caairliagh: Of the leadership blueprint? 245

The Minister: Yes. The Caairliagh: Yes. Well, we have not had time to study that. 250

The Minister: Right. That gives you the new set up. The Caairliagh: Right. Okay. So there is a variation then away from what is recommended in the Beamans Report. 255

Q14. The Speaker: Could I just follow up on that? (The Caairliagh: Yes.) Mrs Morris, your title there is described as Managing Director for Acute Services, which was

the title used in the Beamans Report. I think you were introduced as Executive Director for Health. So that is a redundant title that has been superseded, has it, over the summer?

Mr Charters or the Minister. 260

The Minister: If I allow Mr Charters, please. Mr Charters: Indeed, I took a position early on that ‘silo-ising’ the hospital, which is what I

feared would be the result of the recommendations as outlined in the Beamans Report… I do 265

not think that was their intention, but nonetheless having a post that was specifically about heading up the acute hospital, as opposed to the problem, as I see it, which is actually how the whole health economy works together across the community and across the hospital and indeed with other disciplines, like social work and therapy services, was a key issue.

The view I took was that we needed someone to be the strategic lead, an executive lead for 270

Health as part of the leadership team that I have outlined in the blueprint that you have, and I am happy to answer further questions on, so that we could take the whole system, a whole picture view across the community and the hospital's place within that whole picture of Health and not just a slice or a silo element of it, which is what I feared just having strategic leadership of the hospital was going to create. 275

The Speaker: Thank you. The Caairliagh: Okay. Mr Crowe, any questions? 280

Q15. Mr Crowe: Could I just ask Mr Charters, it mentions in the Beamans Report a governing

board overseeing the hospital, what are your thoughts on that and is that coming into fruition?

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Mr Charters: I agree with that. I agree with the Beamans recommendations in relation to the 285

need for a governing board and a partnership board and there are models, good models in place across children and social care as well and evidence of that working.

So my intention is, with Michaela, to implement that board, but again to take a community health and acute health perspective so that we look at the whole system and not just the hospital. 290

Mr Crowe: Thank you. Q16. The Caairliagh: Okay. It is probably an unfair question to put to Mr Charters and Mrs Morris, but I will ask the 295

Minister because he has been in Tynwald Court for a number of years now, but the Report of the Tynwald Standards and Members’ Interests Committee, you might cast your mind back to that, and it was on the conduct of the former Minister, Mr Anderson, that Report was laid before Tynwald in February 2014 and in that there was a recommendation which drew to the attention of this Committee that, and I quote: 300

‘… a serious catalogue of errors and failed communication on a basic level…’

That is what was brought to our attention about the state of the health services and in

particular Noble’s Hospital at the time. My question, Minister, is what have you done about this? 305

The Minister: Well, I think you are looking around and seeing an entirely new administrative

set up. When that Report was brought out, that was purely the health service. I have now got to manage two Departments and put them into one and I suppose one of the benefits, you could say, of merging two Departments is that it enabled us to look at a new structure. There was, you 310

could say, double the management and so we were able to choose the way forward with… I am not saying a new broom. There was some of the old management who decided that they did not like the look of the new Department and retired early and that enabled me to bring in a new team.

One of the reasons it was mentioned earlier about the difference in title for Mrs Michaela 315

Morris was that one of the complaints I had when speaking with various professionals was that there was not a seamless transition from when you were in hospital to when you were out in the community. It was two different departments and it just was not joined up. So once you were better in hospital it was not necessarily that you could then go straight back home and so we felt that by altering… 320

There is a lot happening in the Department at the moment. There have been incredible changes and I think it is premature to go into lots of detail at the moment. We are just building up a new structure for the Department and once we have got everyone in place and we are aware of all of the problems then we will be moving forward.

But I think when you are running a Department you must have firm foundations in your 325

management team making sure that they are talking to one another. I think when I took over and found that whilst people were working in their individual areas, they were not communicating together. So those are the changes that we are making, but there are significant changes in personnel.

330

Q17. The Caairliagh: Just as a reminder though, Minister, the separation of the Department of Health and Social Care did not prevail for that long. It is not that long ago when in fact the two were one Department and then they were separated. (The Minister: 2010.) Yes, just a few years ago.

But of course this Report, which was laid before Tynwald and approved in February this year, 335

did raise some alarm bells with us in terms of a basic communication problem. We are not

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talking about a basic communication problem at a managerial level or a leadership team level, but at a basic level going right down to grassroots. Now, whilst you are busy putting in a new team and putting in a new system for managing the delivery of both Social Care and importantly Health, we would not like to think that you will forget about the soldiers, if you like, in the field 340

at the moment who are still trying to work in a system that looks as though it is going to be radically changing for them. Of course morale, as we know, has been very low for some considerable time, especially under the previous leadership of this Department.

So what you are saying then, Minister, if I am correct, is, ‘Give me time. I am putting in a new team. The Chief Executive is trying to put in a new leadership team to improve the cohesion 345

between the two levels, Health and Social Care.’ How long do you think that will take? When will you be able to address the shortcomings in the field?

The Minister: Well, it is a continuous. It is something we are doing all the time. It is not that

we are not doing it now, it is just… you are sort of building up to a crescendo. 350

First and foremost I would like to point out that I regularly e-mail, and mark e-mails to all the workforce, with the changes that are being made. When new appointments are made the workforce are kept up to date. I have done a whistle stop, whirlwind tour of most of the facilities in the Department. I have not got everywhere yet, but with the other Members we are getting out and meeting all the people and listening to what they have got to say. So I hope that you do 355

not feel for one minute that we are in our little ivory tower plotting to turn the Department around without involving the employees of the Department of what is going on.

I have always said that to get where I would like to see the Department go is not just going to be a quick fix of a matter of months. I would say this is a two or three-year project to turn the Department around to get both satisfactory waiting lists and morale and the efficiencies that I 360

am looking for across the whole of the Department. This is a big Department. It has got a gross spend of £240 million a year. It has got nearly 3,000 employees. It is a significant job to do and a few months is not going to see rapid results.

We have a number of announcements to make on efficiencies that we are making over the coming months and we will be updating Members of Tynwald and Keys with the changes that 365

we are making and the improvements to the people of the Isle of Man. So it will be a continuous cycle and roll out of improvements for the Island, but it is not something… Hopefully when we meet again, say, in 12 months’ time, you will be a lot happier with the improvements, but there will be still so much more to do. It is –

370

The Caairliagh: Well, I think, Minister, we might have you back before 12 months’ time. As I said at the onset, we have got a lot of ground to cover and time is marching on, it is not on our side.

Mr Speaker, do you have anything? 375

The Speaker: No. I think move on. Q18. The Caairliagh: No. Okay. We have had a look and studied the Mersey Internal Audit Agency Review of Management

Information and the follow-up Report which was issued by Internal Audit in February this year. 380

Very briefly, can you give us an update on this work, please? The Minister: Right. I am just seeing who I have got down with the details on that. Mr Charters: It is me. 385

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The Minister: That is you, Mark. Can I ask Mr Charters to give an update on – The Caairliagh: If you are unable to provide an update on some of these questions that we

have today, we would welcome you writing to us or e-mailing to our Clerk, Mr King, with that 390

relevant update. We do not want you to struggle in trying to find the answers, with you having been here such a short time, but nevertheless we would like an update.

Mr Charters: I am more than happy to provide an update for you. I can say that a key area of

development for us is our use of performance information… our collection of it in an intelligent 395

way. We have got lots of data. I do not think we have translated that data very well into information that drives improvement and tells us where we are strong, weak and indifferent. So one of the key requirements and in the blueprint that you have in front of you, you will notice that one of the key processes is about heading up, leading and developing out performance and business management. The feedback from the Merseyside Internal Audit Review will form part 400

of the improvement requirements that we have in this area and the developments that we have in place.

Q19. The Caairliagh: Okay. Can we move on then to the Medway system? Just very briefly, has the upgrade taken place 405

yet or is it still in process? The Minister: It is not due to start, to actually happen until 2015. It is quite a lengthy process

of going through various stages. If you can just bear with me a second and I will just get them. It is – (Mr Charters: Four.) Number four is it? 410

Yes, the first key milestone since the contract was signed has been reached successfully. The hospital and System C are presently working together on mapping future business processes on Medway with each of the key areas undergoing functional build sessions. There is a lot going on. We plan to go live mid-July 2015.

415

Q20. The Caairliagh: Mid-July. Okay. Thank you. If we can now turn to health service delivery and it has been touched upon, very briefly

today, but we as a Committee have had a look at the Discharge Audit Reports for 2012 and 2013 and we were quite frankly very shocked when we did see them.

Bearing in mind that Mr Charters is focusing on strategy and vision for closing the loop or the 420

shortcomings between (a) a patient being discharged and (b) the backing being there for that patient be able to return home with the support that is required, of course the Discharge Audit Reports show all the shortcomings that we have not had a seamless transition from Health into Social Care. Is that what you are currently working on Mr Charters?

425

Mr Charters: Indeed, and I am not going to say we are doing a very good job at both preventing admission and the flow into hospital or indeed promoting effective discharge out of hospital. There is room for very serious improvement.

Step down facilities, as they are called in the UK, are pretty scarce on the Island. Discharge planning should start on admission and I am not convinced it is at the moment, or it is patchy 430

certainly. Resources in the community to enable that flow from acute hospital in the community and back home equally is something we need to develop and is, in my experience of UK models, virtually non-existent.

So we have a huge opportunity in terms of developing and making the systems work in a way that allow that flow out of hospital into and back to an independent or as independent as 435

possible position, and that includes social care as well as community health services.

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Q21. The Caairliagh: Sure, but you are going to need the full co-operation of the consultants, aren’t you, in respect of this?

Having read these Discharge Audit Reports and gone over them several times ourselves, as a Committee, it appears to us that there is no willingness to do really well for the benefit of the 440

patients on behalf of the nurses, but there does not seem to be an awful lot of our co-operation or co-ordination between the nurses, social workers and the consultants.

Mr Charters: From the practitioners that I have met, I have not met anyone, a consultant,

nurse or social worker, who does not want to do a good job, that does not want to be able to 445

enable their patient to flow through in a positive way through their service and into being as independent and as healthy as possible. The resources, the pathway have to be there in order for consultants, nurses, social workers, therapists and GPs to be able to work in that way and work around the system with the tools that we make available for them, and they are not in place at the moment in the way that will enable them to work in that way. 450

Is some behavioural change needed? Are there some new ways of working required? Absolutely. Absolutely, this is very much part of the new vision and the new arrangements that we have put in place.

The Caairliagh: Okay. 455

Mr Speaker. Q22. The Speaker: I just want to follow on. The 2012 and 2013 Discharge Audit Reports were highly critical and one of the basics that is

not being adhered to is the 24 hours’ notice of discharge, and the pharmacy requires that. 460

Consultants are supposed to give 24 hours’ notice. It does not happen. It is not new policies, it is adherence to long-standing common sense policies that seems to be at fault.

How serious is the position, because I have an example to give you where I believe it is still failing, the discharge policy?

465

Mr Charters: I can do nothing but agree with you. I cannot tell you that at the moment it is any better than where we have been for some time. The job we have is to make this, along with other areas, processes and procedures through the hospital into the community and the integration between the two better.

470

Q23. The Speaker: If I was to tell you that at the beginning of this month there was… I am aware from a constituent who was collecting her 85-year-old mother, who had been discharged, and she had to wait six hours with the mother, who had dementia, outside the ward while the take-home drugs were prepared and she discovered that there was a drip needle still in her arm under her cardigan. This was only a matter of two or three weeks ago. 475

So not much, Mrs Morris, has changed from the highly critical reports of 2012. Very little seemed to change from 2012 to 2013 and little seems to have changed from 2013 to 2014. What assurance can we have that this time next year the Audit Discharge Report will report better?

Mrs Morris, perhaps… 480

Mrs Morris: Thank you. I am personally not aware of the report yet. As I have explained, 1st September was my start

date so I am in the middle of my third week and it has not yet come across for my attention. But, certainly, recognising that significant improvements, as Mark has just said, absolutely

need to be had and it is a matter of… I think that the fact that my role has been extended across 485

the whole of the Health economy, and the whole arena, and working very closely with my new colleagues in the management leadership team that Mark has been describing earlier, it is about

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working together to make effective changes, because I cannot just make those changes within Health; they need to be made across the whole of the Health and Social Care side of things.

Certainly, it will be a very key priority for making sure that those sorts of audits are addressed 490

far more rapidly than they previously have been. The Caairliagh: If I can just add, it will make for much greater efficiency (Mrs Morris: Indeed.)

and, no doubt, economic savings in the long term, so I would suggest that perhaps – and we appreciate you are only here five minutes so far and you have not really had time to settle down 495

but – if you do get an opportunity, would you, (Mrs Morris: I certainly will.) please, take a look at those audit reports, because the young woman who put them together and did all the legwork and research has worked extremely hard, but does not appear to be getting any support from anybody or any ownership of the problem and someone has to take ownership of the problem in order to resolve it. (Mrs Morris: Indeed.) Okay. Thank you. 500

Mr Speaker. Q24. The Speaker: Just to make a comment. In the report, which you will read, are instances

of patients being on the rehabilitation ward for in excess of a year, which is absolutely appalling, and the continued delays in discharges and the lack of at-home provision that has been made 505

that causes them to be, in terms of great financial inefficiency, nevermind personal distress, sitting in a rehabilitation ward for 12 months, are nonsensical.

So I am interested, Mrs Morris, when your introduction discharge policy was one of the areas that you have got a deep familiarity with –

510

Mrs Morris: It is certainly an area that I have worked in a lot. In the UK NHS it is bread and butter for the service there and, definitely, I am very familiar with what should be happening; but I am not just familiar with what is happening currently. I will now read the report.

The Speaker: Thank you. 515

The Caairliagh: Thank you. Mr Charters: Madam Chairman, could I add something? (The Caairliagh: Yes.) We discharged, a few weeks ago, someone who has been in Noble’s for two years. That is 520

disgraceful, in my view. I think we absolutely need to do something very seriously about making sure that the people in hospital need to be in hospital, because they are not healthy places and people who do not need to be in hospital are not. I fully support your view on that.

The Minister: And can I say, (The Caairliagh: Minister.) Madam Chairman, that personally I 525

came across… I went to visit a member from the Commonwealth who had come over to visit the Island and had been taken ill – from Sierra Leone – and came across the lady on the ward and it was pointed out to me that this problem had been going on for two years; and within two months we had that person in a far better place for her and had freed up a bed in the ward.

So I am taking action. The three of you know what faces me, but I can assure you that I have 530

put together a very… and when I went after my new team, if I had not got top people I would have been in trouble. Instead of having career civil servants in charge of my areas now I have qualified professionals who have the sort of relevant experience to take it forward.

My job is massive but I will deliver it. We are all aware of the problems and, as the Minister, when you get under the bonnet and see the problems you are just aware of what has to be 535

done. We have a committed staff, we have good facilities and, with a good management team that we are putting together, I feel that our meetings in the future will be far more favourable.

The Caairliagh: We are forever hopeful that you will be successful in this.

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Mr Crowe: Madam Chair, can I just – ? 540

The Caairliagh: Yes, please. Q25. Mr Crowe: Is bed blocking quite a significant problem, Minister and Mr Charters? 545

The Minister: Yes, to be blunt. In one of my first meetings it was a complaint given to me from some of the consultants, that

there were people in wards that should not be there – that they were effectively blocking beds. I have done walks around Southlands where we have four step down facility beds and I am

working on a project at Ramsey District Cottage Hospital to provide some step down facilities. 550

Once I have got them in place in the coming months we will be able to relieve 10 people that do not need to be in Noble’s Hospital – to put them in the step down facility whilst they are being sorted out.

That is why you can say that the merging of Community and Hospital was so important. We could not allow these to be two separate empires. We had to bring it together to make sure that 555

the minute your consultant doctor says that you are fit to go home, that you can go home or that there is somewhere for you to go, rather than blocking the bed.

I think that the daily rate to be in a ward in Noble’s is £370, so if we could have something that is better for you and saves the taxpayer money then it is a win-win situation; but that has not been happening and I have made it an absolute priority to get on top of it. 560

The person who had been in for two years… I was horrified and I took action straight away; but even then it took me two months to get all the procedures done.

We are committed to making the changes that I am sure you are looking for too. Q26. The Caairliagh: Good. We are encouraged to hear it. 565

What I would ask you for now… the next two questions – if you could provide a written update for us we would be very grateful.

The first one is the West Midlands review of emergency care – this is something else that we have had a look at – and the associated action plan which was submitted to us by Mr Kniveton on 16th June this year. If you could please provide us with a written update on how this is 570

progressing? Also, we have looked at elective colorectal surgery and the action plan there. They were

submitted to us, again by Mr Kniveton on 16th June 2014. We would appreciate an up-to-date report on how we are getting on there, because that was quite a serious matter at the time.

As we are coming up close to an hour almost, I am going to skip straight from that. We will be 575

going back to Social Care, but I want to skip and I want to cover the issue of housing. On 16th July, Tynwald approved two shared equity purchase schemes. Both were drafted to come into effect on 31st July 2014. Have they now been implemented?

The Minister: Yes. 580

Q27. The Caairliagh: They have. Can we ask, Minister, at the time that you were taking this

through Tynwald, had you had good negotiations with the banks, in terms of: were you happy at the time that they were geared to help people to make this happen?

585

The Minister: I had been told that the banks were supportive of the proposals. Effectively, their risk has reduced – their exposure to risk – with us taking 20% to 30%. They were happy with that process. That is what I had been led to believe at the time – that they were all happy.

Q28. The Caairliagh: You were led to believe by whom, may I ask? 590

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The Minister: By my officers. Q29. The Caairliagh: By your officers. Okay. But it would appear that they were not actually geared up. They might have been happy with 595

the new scheme but they were not geared up to deliver it. The Minister: As it happens, we did in time. There have not been any delays. The banks

needed to go off to their head offices and that could take between four and eight or four and ten weeks to get the process together. 600

Some banks have come on stream but it is worth pointing out that it takes us six weeks to process an application. So if you come to us with a new application then it takes us up to, as I say, a six-week period of checking, getting all your details together. We give you an approval, you then go to the bank with that approval and work with them on the mortgage.

We now have two banks delivering on the new scheme, with two who have supported it to 605

their head office, and they expect to be up and running pretty soon. Q30. The Caairliagh: Okay, but during that, there was a period, was there not, where there

was a bit of a grey area because those people who had applied and had their application approved by the Department, as first-time buyers, had everything on standby – pending finding 610

the right accommodation – and then once they found the accommodation, because of the time of the Tynwald approval of this scheme and its introduction, the one scheme that they were involved in – and everything was set up, in gear and ready to go – suddenly fell short and was flat, and they had to start all over again with the Shared Equity Scheme?

There were a number of young people who fell into that trap. Why did that happen? 615

The Minister: That was not technically the case. Anyone who had received an offer and had

all their paperwork in place prior to the old scheme ending was entitled to carry on on that house.

If they had an individual house in mind to buy and they had a letter of approval from the 620

Department then legally we could offer them… that continued whilst that purchase went ahead. However, the very public one, which I believe one of the Members of the Committee it was

one of their constituents – which was in all the newspapers – had not got proof of earnings to the Department in time.

I have records that they were actually chased by my officers to get their proof of earnings in 625

to us from their employer, their employer had not delivered that. They omitted to tell that in their story, but we have the records showing the phone calls to them, chasing them. It was a very public case but –

Q31. The Speaker: If I may come back on that. The scheme came in on 31st July. (The 630

Minister: Yes.) It is the case, though, that no banks had any products in place at that time, (The Minister: Correct.) did they? Are you saying that two banks now have products in place?

The Minister: Yes, and with people already in the process. One has already been approved

with one bank and I think there are eight going on with another bank at the moment. 635

Q32. The Speaker: Can you tell us when these were put in place? These schemes – the two

banks? The Minister: I have not got the exact… I have been away for two weeks but I know Isle of 640

Man Bank have been… a couple weeks ago, when they came on line with their product and HSBC have already approved one.

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Q33. The Speaker: I was given information that banks would not have any potential mortgage products available until the second week of October. 645

The Minister: No, there are two banks – Q34. The Speaker: So that is incorrect? 650

The Minister: That is incorrect. We have two operational at the moment. Lloyds expect to be within operation in the next couple of weeks, as do Barclays who are supportive of it.

Q35. The Speaker: What more should have been done to ensure… We have correspondence

with the Department which concedes that the banks did not get their act together. What more 655

should have been done to ensure there was a better lead-in time? The Minister: I did, obviously, have meetings over this, because I was not happy, myself, with

the way we had performed over the initial period. The officers felt that because this was going through Tynwald it could have been amended at any time and, therefore, they did not want to 660

tell the banks it was going from a certain date until it had actually got Tynwald approval. I took a different attitude from them and said, ‘Really, the minute we decided to take it to

Tynwald you should have advised the banks that this was likely to happen and could they, please, run with this system, with their head offices, so that when we delivered on the date it was obviously… 665

Back to my seamless transition between Health and Social Care – I wanted a seamless transition between the old scheme and the new scheme. Regrettably, that had not been properly planned for. Fortunately, you could say, with the lead in, with a new applicant taking up four to six weeks, two of the banks have come on in that period of time and there have not been the delays, but – 670

Q36. The Speaker: Have applications been made with those banks, (The Minister: Nine.) to

your knowledge? The Minister: Nine… applications. 675

The Speaker: Nine? Nine applications? The Minister: Not ‘nein’! (Laughter) 680

The Clerk: German? The Minister: Not ‘nein’! Jawohl! (Laughter) The Speaker: Thank you. 685

The Minister: Eight with one bank and one with another. The Speaker: Thank you very much. 690

The Caairliagh: Thank you very much. Mr Crowe, do you have any questions on this? Mr Crowe: No, thank you. 695

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Q37. The Caairliagh: No. Okay. In December 2013, Minister, the then Minister for Social Care, Mr Robertshaw, said the

Department would be progressing with means tested rents for public sector housing from 2015, before any further increases were going to be brought in for public sector housing tenants.

Bearing in mind that these tenants have already had something like a 30% increase in rent 700

over the last couple of years, plus the introduction of the ‘toilet tax’ and now we have had an announcement that gas is going to be increased, can I ask you what progress is being made in terms of bringing in this vital measurement tool – means testing?

The Minister: Yes, is it okay, Madam Chair, if I make a statement for you on the whole 705

process of the means testing and what the Department plans to do? The Caairliagh: Well, we have had promises from a former Minister who said it was going to

happen; it would come in, it was all ready to come in in 2015. We are only three months away from 2015. 710

Yes, by all means make a statement. The Minister: Okay. The original introduction date of April 2015 has been deferred following extensive research

into the feasibility of introducing means tested rents for the public sector. The current position 715

regarding legislation and information sharing has confirmed it is not possible to achieve the original 2015 timescale.

Following the feasibility study completed within my new Department of Health and Social Care, it is clear that there is a need for more appropriate legislative powers to be progressed before means testing rents can take place. It is important that any policy we introduce is 720

understood by the user, robust enough to prevent fraud or loopholes and does not have unforeseen consequences for the vulnerable. Work is ongoing to determine the strategic policy on means testing across Government, to which my officers are contributing.

In the meantime, my Department will be consulting with all local housing authorities to seek their views on the annual rent increase for 2015-16 and this will be progressed by the 725

Department in the usual manner. A statement on agreed rent increases for the sector will be made in November as per usual.

The Department will need to make a decision on rent increases for 2015, following the consultation and we will be having a Department meeting on 19th September and we will be waiting for feedback from the local authorities and what they would be looking for. We will be 730

discussing it as a Department. We will be making a recommendation on the increases and we will have that information for November.

Q38. The Caairliagh: I must say, on behalf of the Committee, we are somewhat shocked at

your statement, although it is not unexpected in some respects. 735

So what you are saying then is that, despite the assurances given by the former Minister, Mr Robertshaw, there is no legislative provision to be able to bring in means testing?

The Minister: The Department currently has no legislative provision to bring in means… 740

The Caairliagh: So there was no law – The Minister: It does not have the vires. (The Caairliagh: Okay.) We will need to bring out

new primary legislation to do the means testing. 745

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Q39. The Caairliagh: Okay. So a Minister makes a statement, tells all Members of Tynwald this is happening and it is coming in in April 2015, in the knowledge that, in fact, it could not because he did not have the vires, or the Department did not have the vires, to do it.

That is one thing in itself. Can I ask you to comment in terms of… you are going to consult with the local authorities in terms of rent increases for the next year or two? 750

The Minister: That is standard Department procedure. Q40. The Caairliagh: Sure. Will you be encouraging them to go for an increase in rent or will

you rather be recommending that things stay as they are until you get all this mess sorted? 755

The Minister: If you look at the budget for the Department prior to me taking over, there

have been budgeted increases of 10%, 10%, I think another 10% and then 5% increases. I think the first year was a 10% increase; last year was a 5% increase because the Minister said he was introducing means testing. 760

We will be listening to the local authorities’ feedback and making a decision. That is something that has not happened yet. I was made aware that means testing will not be able to take place because we did not have the vires, at the end of June.

The Caairliagh: Yes, Mr Speaker. 765

Q41. The Speaker: Just as a follow up – thank you, Chair – the policy of means testing is an

example of a policy intention by Government that needs to be underpinned by statute. Given that the changed nature and increased complexity of what a single Department is

doing, as was alluded to earlier, in terms of Health and Social Care, can I ask whether you have 770

undertaken any strategic review of the vires, the primary and secondary legislation that is in place, to enable you to discharge policy in the future.

Clearly, means testing is one example of where it did not happen. Might there be others? The Minister: I am the new Minister for Health and Social Care and I have got to look at the 775

policies. I am taking them forward now and I have got to make sure that the assumptions made by the previous Minister were correct.

We have had an investigation, shall we say, into… trying to do research into the income levels that people have in the social houses on the Isle of Man. We have looked at 50% of the levels now and the figures that I have been provided are different than the figures that the previous 780

Minister had been working to and I need to go away and make sure that everything is correct. So I will be taking forward in the future a means testing proposal, but it will have to be done once I am content that all the information I have is correct, stands up and that we have the vires.

The research I have had since I found that out tells me that it will have to be new legislation and you know yourself how long new legislation takes to get through. So I was surprised that 785

was the situation, but I am not prepared to take anything forward until I know it is correct. Q42. The Speaker: My question was really using that as an example of a decision that you

may feel that you should make to review all policy, given the complex responsibilities that the Department has, to ensure that it is compliant with legislation. 790

I am thinking of areas like data protection, information sharing. For example, if there are to be new functions or structures set up to engage with families and the Social Services aspect, the legislation will need to be in place.

The Minister: Yes, and I suppose you could say that is why I have brought in my new team – 795

especially Mark on the Social Care, with the experience he has in that area. I will be making sure

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that all areas are checked to make sure that we do comply. I am not led to believe that there are any areas that we are not complying with.

I found out at the end of June that we did not have the vires, so it is not as if we have gone ahead and done something – we have not – but the Department did not have the vires in the 800

first place. It can get the vires; it can go to Tynwald and get those vires to do it or it can be done through Treasury, who I believe have the vires; but we, as a Department, do not have the vires.

Q43. The Caairliagh: Treasury might say they have the vires but that, again, is questionable. Can I just halt you there for a moment, Minister? It is deeply concerning to learn that you 805

have a new management team coming in, a new focus, new energy, new strategy, new vision, but it would appear that there is an apparent misunderstanding, in terms of your legislative ability in terms of vires to do anything. My question to you is: is there anybody on the Department who you could call upon as your legislative officer, your legislative adviser?

810

The Minister: I have a very good person in the Department – a lady called Sam McCauley who is excellent (The Caairliagh: Okay. Right.) and is one of the very good staff I am glad to retain in the Department. So, yes, I do have that expertise.

Q44. The Caairliagh: I cannot ask you to make judgement or comment on your predecessor, 815

but would you agree with me that really a Minister, before making any kind of policy statement in Tynwald Court that this will happen and that that will happen, that he or she needs to check with their legislative officer that, in fact, they do have the vires to do what it is that they are wanting to do; and, if not, then do you not agree with us that it is advisable for the Minister then to make the statement that he would like to do it but he is going to need new law (The Minister: 820

Madam Chairman – ) to put everything into place? The Minister: I cannot put myself in the position of the previous Minister because I was not

there at the time so – 825

The Caairliagh: No, I am not asking you to. No. The Minister: So I am unable to answer. I do not know how he was advised, what areas he

did his own research on. I personally would have thought he would have been advised whether he had the vires or 830

not, but I do not know what was happening during that time. I have come in, looked at it, had it thoroughly investigated and found out we did not have the vires and some of the figures that had been worked on were not as good as I would want.

If I am going to take something forward it has got to be pretty detailed and robust to take to be scrutinised by the likes of yourself and the Speaker and Mr Crowe. 835

Q45. The Caairliagh: Are you satisfied that your Department – the social care aspect of it and

housing – have got proper control over that aspect of the Department? Or do you not feel that perhaps there might be a little bit of interfering from the central office, shall we say – the Cabinet Office? 840

The Minister: Obviously, there have been allegations into that. I have had to take control of

the Housing office for the Department following Mr Cannan resigning from, not the Department itself but from Housing.

845

Q46. The Caairliagh: Can I just ask you… It is most unusual in our experience – and Mr Speaker and I have been here, and Mr Crowe, for a very long time indeed... In our understanding, when a Member with political delegated responsibility in an area resigns from

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delegated responsibility he therefore resigns from the Department per se. You are saying that Mr Cannan is going to remain on the Department or he will not have the portfolio for Housing. It 850

begs the question: why stay on a Department if you have no delegated responsibility or portfolio?

The Minister: But he does. Mr Cannan had delegated responsibility for Housing and

Children’s Services. He has resigned from Housing, not as a result of falling out with the 855

Department, but as perceived interference by him of another Department in areas that he had delegated responsibilities for.

Q47. The Caairliagh: So what will Mr Cannan do now in the Department? 860

The Minister: Children’s Services. He had two areas that he had delegated responsibility for. So instead of having two, he will go down to one.

Q48. The Speaker: The obvious question is what are you, Minister, going to be doing to

ensure that this alleged interference, by another Government Department, another ministerial 865

colleague, will not impinge in this most unfortunate way on the work of your Department that apparently causes Members to resign? There is something far wrong, is there not?

The Minister: This only happened... If you can bear with me, I can give you a little bit of the

history so you can understand how far I have come along on this issue. 870

On Tuesday morning at 8.30 a.m., I received a phone call from Mr Cannan saying how unhappy he was that he had attended a meeting on Monday evening in the north of the Island, where local commissioners had been present and the Treasury Minister had been present, and it had been stated there that there would be a meeting on the Thursday, with three Ministers in attendance, to discuss a number of issues; and housing was one of them. The members turned 875

around to him and said, ‘Well, what’s your take on it?’ He knew nothing about it. That is what I knew first thing on Tuesday morning. I was in the middle of a series of

meetings, but by Tuesday afternoon I had set up an appointment to go and see the Chief Secretary and Minister Robertshaw over this.

In the interim period, sadly, Mr Cannan had decided to resign from his delegated 880

responsibilities in Housing and I did have the meeting where I was assured that was not the case; that at no time had Minister Robertshaw intended to discuss housing in the local authority meetings for the north of the Island; it has been purely local authority reform.

Obviously, the Chief Minister is not on the Island at the moment and I will have to have discussions about that; but I have been assured that this has been a misunderstanding and that 885

these meetings were purely for local authority reform and were not to discuss housing at all. So I have got two different stories. It only happened yesterday, as far as I was concerned, so – Q49. The Caairliagh: But surely housing would come into local authority reform, wouldn’t it,

bearing in mind that many of the larger local authorities do have housing stock themselves? 890

The Minister: I can only go on what I am told, Madam Chair – that it would be for local

authority and housing was not on the topic. I have been away for two weeks. I got back late Sunday and I sort of walked into this. 895

Q50. The Caairliagh: We have not had confirmation but we are also hearing that you might be losing another Member in your Department in a particular delegated area, because of unhappiness. Quite why, we have no idea.

Are you aware that there is another political Member who is not happy where he is placed at the moment? 900

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The Minister: Yes, I do have a political Member who is unhappy with his area. Q51. The Caairliagh: Is this, again, due to interference from the Cabinet Office or – The Minister: I am not led to believe so. 905

The Caairliagh: – interference from the centre? The Minister: I am not led to believe so. 910

Q52. The Caairliagh: No, but it does not make your job easier, Minister, does it, when you have come in with such a heavy load and such a lot to deliver?

You are concentrating on getting your leadership team management sorted for delivery – it might be a good idea to keep an eye on your political Members because without their support it will be a lonely place in Tynwald Court. 915

The Minister: Being Health and Social Care Minister is a very lonely place anyway, Madam

Chairman… but it is one I am happy to do and I look forward to making the proper changes. I find in politics that there are things that sometimes you are not happy with and you have to

decide whether you are just going to keep on going for the greater good or hand… It is 920

disappointing that we are where we are but it is beyond my control. If people feel or perceive that they are being overruled by another Department then I would

have liked to have seen the evidence first. It is allegations at this moment in time. Both parties are denying something that I did not attend, I know absolutely nothing about and there is no paper trail, as far as I can see. 925

It is disappointing that we were not able to get to the bottom of the story first and then a decision was made.

Q53. The Caairliagh: I am sure there is more to come in the wash in respect of that particular

issue. 930

Regarding the feasibility study then that is going to be conducted, you will appreciate, Minister, that there will be huge concern out there in the public arena, from the local authority tenants who were anticipating that means testing would come in. Particularly those who are struggling financially were hopeful that the means testing would identify that they were either paying too much or enough, and would not warrant an increase in rent. 935

Of course, now, while this whole thing is being reviewed – quite rightly, by the sounds of it – it gives them a lot of concern, because they do not know now what is going on; will the rents continue to increase and charges continue to go up, while their benefits and their pensions remain as they are?

A number of Members, I think, have had a chat with us and are quite worried about the 940

winter coming on and the predicament that some of these people find themselves in; which again is going to fall on to you and your Department of Social Care to pick up the pieces from it.

The Minister: Yes, I can only apologise to them on behalf of the Department but I am not

prepared to take policies to Keys and Tynwald unless I know that I have the vires to do them and 945

that they are based on sound information, and I have got to make… Some of the assumptions that have been made, when we have actually logically followed those assumptions into doing proper checks – because when you come up with a policy I am sure that the previous team will have made assumptions but they will have then moved on to do the checks to see whether those assumptions are correct… Some of the assumptions were not correct, from what I have 950

found out. Therefore, I cannot rush it; it has got to be done properly. We have got to make sure –

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The Caairliagh: We fully appreciate the situation you are in and, of course, we have heard the issue described as being fundamentally flawed. I think that probably puts it into context, from what you have said, Minister. 955

We are going to move on now to Social Care and I am going to invite Mr Speaker to open on this. Over to you, Mr Speaker.

Q54. The Speaker: Thank you, Chair. I think my questions are primarily to Mr Charters, Minister, but they may well overlap. When 960

you were appointed, Mr Charters, the Government press release, as you indicated in your own introduction actually, made clear that you had:

‘… played a leading role in developing innovative service models and turning around failing services, such as joining up health and social care services in Northamptonshire to deliver a single care pathway and turning around 965 social care services in Bexley before being asked to do the same for the Borough’s children’s services.’

Can I ask from what date you took over in Bexley children’s services and how long you had in charge?

970

Mr Charters: I know I was there for seven years and I came here so that would have been 2007. I initially took over in Bexley, running adult social care services, housing allocations and cultural services, community safety.

At that point, adult social care was in a failing care trust – an arrangement with the local community health services. A turn around Chief Executive had been brought in to that PCT and I 975

was asked to work with him and his team to improve and develop the adult social care services. I did so and we did that together, as I mentioned earlier, in an integrated way with

community health and delivering joint budgets, joint commissioning arrangements as well as integrated delivery across health and adult social care.

980

Q55. The Speaker: Okay. You will be aware that in October 2013 there was a very critical report by Ofsted, where 20

local authorities in England were rated as inadequate for protecting children. (Mr Charters: Yes.) ‘Manifestly and impalpably weak leadership and high turnover of directors are undermining efforts to improve children’s services,’ according to the chief inspector. 985

Of course, Bexley was one of them, as was Northamptonshire. That was in October 2013 and it was based, as you will be aware, on a July 2012 inspection of Bexley. What happened after that? You were in charge then – is that correct?

Mr Charters: The reference to Northamptonshire… I had had no involvement in children’s 990

social care in Northamptonshire. (The Speaker: Right. Okay.) In terms of the London Borough of Bexley, the Council reorganised itself and asked me to

take over the management of children’s social care from April 2011. In doing so, within the first six and nine months I identified significant flaws, particularly in

relation to children’s safeguarding. Previously the external reviews of this service had indicated a 995

good service. Quite quickly my own assessment and some external measurements that I commissioned indicated a different position.

At that point, I raised these failings and within a few months after commissioning an improvement plan, Ofsted inspected and, indeed, verified my own conclusions. Looked after children was ‘good’ and, indeed, we had some ‘good’ fostering services; but in terms of 1000

safeguarding we were ‘inadequate’, which supported my own assessment of where the Council’s position was.

I have to say that was the best thing that happened for children’s safeguarding in the London Borough of Bexley, because it enabled me then to have both the resources and the focus and

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the prioritisation to implement an improvement programme, which then completed over the 1005

next two years. In March, prior to my departure in July, we had a re-inspection of Ofsted and I am pleased to say we were lifted out of ‘inadequate’ and they supported the improvement planning that I led.

Q56. The Speaker: Yes. Thank you. 1010

So with that turnaround in mind – and I am quite sure it would have been one of the factors that… the reason you are here in the Isle of Man. Given that time frame – so that is something like 18 months to two years – how were you able to improve things sufficiently to get the Ofsted rating change from ‘inadequate’ to ‘adequate’?

1015

Mr Charters: It is a very complex issue. It is a bit like a car crash; it is never one cause, it is a whole combination of factors coming together at the wrong time and then putting those factors right to make it better.

So improvements were based on, fundamentally, a cultural change. They were practical improvements. For instance, making sure social work staff were fully supported and trained and 1020

skilled; that there were audits and arrangements in place to make sure that the outcomes they were delivering were good and that we knew that.

We talked earlier about performance – the importance of performance management and a framework that tells you how well you are doing and your service is doing, from scrutiny and looking at the outcomes that were being delivered; through to, obviously, resources – a key 1025

issue, but invariably making better use of the resources that are available; that was another key element of our improvement.

Recruitment and retention. A service, in my experience, is only ever as good as the staff, and the abilities and the quality of the staff, that you have got serving the public and, therefore, an active and pro-active recruitment campaign that got the right people, the right staff, in the right 1030

positions… was a critical element of that. But it all started with a very clear vision, a very clear strategy, a focus on where it is we are

now and where did we need to be and how we were going to get there. Effectively, strong and positive and insightful leadership is, in my experience, the first and foremost element of improving any service. 1035

Q57. The Speaker: Would you be confident then of achieving this in the Isle of Man in a

similar time frame? Mr Charters: I would. 1040

Q58. The Speaker: Would you prefer it in future to be inspected by Ofsted, rather than the

Scottish Inspectorate? Mr Charters: I would. 1045

Q59. The Speaker: Okay. Do you have any consultants in mind to assist you with these policy

improvements? Mr Charters: I do. 1050

Q60. The Speaker: Do you have an idea how much they are going to cost and will you be

coming to Tynwald for approval of any such costs? Mr Charters: I have not formed any specific proposals at the moment. I know, clearly through 1055

my work in London, of key people who have the experience and insight that can help us but at

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the moment I am not in the position of knowing what specific expertise is needed. But when I am in that position, working with the current management within children’s services, I will be doing that, yes.

1060

The Speaker: Thank you. Q61. The Caairliagh: If I could just come in there, Mr Speaker? It is interesting because, of course, your ideas here are somewhat different from that which

prevailed previously; but we seem to have a problem, do we not, in the Isle of Man of recruiting 1065

and retaining well-trained, good social workers? That is going to be your first hurdle, is it not? Is there not a short coming there now?

Mr Charters: Recruiting and retaining good children’s social workers is a problem

everywhere. It is a problem in the UK; it was a problem in Bexley. 1070

One of the key solutions to that is about focusing on wanting to provide excellent, outstanding social work for children’s services in any area and, therefore, enabling good social work practice to exist, training support arrangements; so, effectively, making an environment professionally attractive for good social workers to come and work for us.

The London Borough of Bexley was not a… well, a lot of people have not heard of it. It was 1075

not the most, initially, attractive place to… It was not a mecca for children’s social work, for example, and yet what we had to do through an active recruitment strategy is sell the virtues of why professionally it was a good place to come and work.

I think for the Isle of Man we have to do the same; employ the same tactics. I think we also have to employ some really perhaps more effective strategies in communicating why living in 1080

the Isle of Man is hugely attractive. I think we can develop more strategies to communicate what those benefits are of living

here, not least the environment; and so put a recruitment and retention strategy in place which really sells practising good social work in the Isle of Man.

We do have similar issues with nursing and other professions that are around, and in health 1085

professions, relation therapy services, in relation to recruiting and retaining good workers but, yes, absolutely, it is very important.

The Caairliagh: Thank you, Mr Charters. Mr Speaker. 1090

Q62. The Speaker: Yes, if I may. You referred to the distinctiveness of the Isle of Man for potential recruits into Social

Services. Have you had time to assess the Island’s distinctive social culture in terms of requirements for child protection? 1095

Mr Charters: In what way? Q63. The Speaker: Maybe I will put it a different way. What do you see, if any, have been the differences between Bexley and the Isle of Man, in 1100

terms of their risks to children and the requirement for child protection policies? Mr Charters: Yes, indeed. As I say, it is week 11 so you will have to bear with me; it will take a little bit longer to

understand the full dynamics and the socio-economic influences of all our services but, from 1105

what I have seen so far, I think social isolation, of giving access to evidence and understanding of where abuse and neglect take place and, therefore, being able to ensure that proper

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safeguarding arrangements are in place; that all agencies are working together and communicating any evidence that they identify.

I think we do have pockets where our services are working in isolation from each other and 1110

that always provides, or can produce, risks in terms of the identification of harm. We do have, in some areas, quite rural environments and, therefore, that transparency of where abuse or harm may be taking place is an added risk for us.

I think we have got to continue with the work and there is good work in relation to the partnership boards and the partnership arrangements and joining the dots with both services to 1115

make sure our safeguarding policies – not just for children but for adults as well – are implemented and understood, and that training takes place across a range of disciplines, to raise alerts and raise issues as quickly as possible.

The Caairliagh: Mr Charters, obviously, you need to get your feet firmly grounded before all 1120

these things you have got to tackle in the next 18 months to two years. It has been said – and in evidence we have received before – to the effect that the Isle of Man tends to over-refer. In other words, the referrals are too high when compared with the actual cases that will result from that, causing alleged nuisance, upset, disharmony and mistrust within the community or the family, from which perhaps someone might have made a referral. 1125

I think perhaps that is where Mr Speaker is coming from – that you will need time, obviously, to have a look at this.

The Isle of Man seems to be confused in terms of what model it is following when it comes to these areas – whether it is a British model, whether it is a Scottish model, whether it is something else – and, of course, as always with the Isle of Man – and something you will learn 1130

over time – we tend to be a little bit behind in terms of the progress of these matters. We might still be administering a particular scheme under a particular government of past in

the UK, whereas it might have moved on or changed radically. So perhaps, unless Mr Speaker has got more questions on it… 1135

The Speaker: I do have a number of questions, if I may? (The Caairliagh: Okay.) I do have a number of questions.

The Caairliagh: Right, okay. I am just watching the clock, Mr Speaker. Do continue. 1140

Q64. The Speaker: You use the term, for example, ‘safeguarding’. I would be interested to know where in Manx legislation the term ‘safeguarding’ is used?

Mr Charters: I am not drawing from Manx legislation, I am using a generic professional term,

(Mr Speaker: Okay.) that is used across children and adults – predominantly, I have to say, in the 1145

UK and so you will have to forgive me if I have brought a UK colloquialism to the Isle of Man. Q65. The Speaker: It is just that the UK – for example, the 2004 Children’s Act – talks about

safeguarding as an objective. What is your understanding of our statutory duties towards children in Manx law? What is 1150

the objective? What are the terms that are used? Mr Charters: I cannot quote you the law. From the information I have seen, I do not think

there is a significant difference between the two in terms of the higher level objectives of the statute in relation to the protection from harm and abuse and neglect. 1155

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Q66. The Speaker: Yes, the statutory thresholds refer to children at risk of significant harm or potentially at risk of harm and that is the threshold for Social Services intervention in the Isle of Man.

In England, where you operated under the English legislation, in Bexley, and developed other services, of course there was statutory underpinning of that. Would you accept that the only 1160

threshold for involving Social Services with families in the Isle of Man is under our Children’s Act; that of child protection – children suffering or at risk of suffering significant harm – and not lower level concepts like wellbeing or safeguarding?

Mr Charters: I do not believe that the state should be involved in running people’s families or 1165

have responsibility for those decisions; they should be with the family. I do agree that the state – in this regard, Social Care – is about protecting vulnerable children

and vulnerable adults, where there is clear evidence of harm, whether that is neglect or abuse. Absolutely, I do agree with that.

What I do think, though, is that many families want and choose to avail themselves of 1170

support in order to prevent situations of deep distress for them, whether that is economic distress or relationships – psychological distress.

One of the key drivers of harm and abuse is adult mental health issues, drug and alcohol issues, domestic violence. These are all key contributing factors. Actually, I do believe that there is a role for us in providing and enabling the provision of appropriate support for families and 1175

individuals to take up. Q67. The Speaker: How would you provide that support? What sort of structure would you

put in place? 1180

Mr Charters: Through an effective prevention and early intervention strategy, which works with other agencies, again in a joined up way to make sure that adult mental health services and drug and alcohol services work in a co-ordinated way, that access to those services is clear and straightforward so that individuals and families can avail themselves of that support when they choose. 1185

Q68. The Speaker: Are we talking about multi-agency service hubs, for example, that they

have in local authorities in England? Mr Charters: We can structure it in a hundred and one different ways and title it in a hundred 1190

and one different ways but, fundamentally, yes; the ability for you or I, or any resident of the Isle of Man, to be able to go to one place and be able to access a range of services at one point, at one time, in a quick, clean and efficient way. Absolutely. It has got to make sense.

Q69. The Speaker: Would that involve an individual of the state being responsible for a 1195

family and sharing information about that family with other agencies? Mr Charters: Information belongs to the individuals. Therefore, if the individual concerned

chooses for their information to be shared with others then that is – (Mr Speaker: Gives consent.) yes – their decision and if there is a formal process that authorises that then that can 1200

happen. If they do not and they do not authorise and give consent for their information to be

provided to others then, no, it should not happen; it cannot happen. Q70. The Speaker: Okay, thank you. 1205

Can you tell us how many families have children on the Child Protection Register in the Isle of Man?

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Mr Charters: I know there are 53 children that are subject to a plan and that is about 2.5 per thousand, which is approximately the same as the UK average; and I was interested to look at those comparisons when I came over. 1210

Interestingly, that has fallen quite a lot over the last 18 months, so clearly there has been quite a lot of work done in bringing down the rate of children that are subject to a plan.

We have 89 looked-after children. Again, this represents a 5.4 average per thousand. The average in the UK is 5.8, so this looks quite a good indicator and that again has been falling over the last 12 months. 1215

Q71. The Speaker: One of the features of the success you had where you were before was

reducing the number of social workers required per case. Do we know how many social workers are required in the Isle of Man to support these 59, I

think you said, families on the Register? 1220

Mr Charters: One of the key measures that Ofsted use is cases per social worker. Professor Eileen Munro did a lot of work in the UK in setting some standards for children’s

social care. Her target was 18 cases per social worker. We are currently at 16 so we are below that target and doing quite well in terms of average cases per social worker. 1225

I should make it clear I did not reduce social workers in Bexley, I enabled them through other arrangements to be able to focus on social work rather than other tasks. So I was able to get better value in terms of them providing social work services and social work tasks.

Q72. The Speaker: What is your view of the time that is spent on needless referrals to Social 1230

Services in the Isle of Man – referrals that do not distil down to child protection; needless intervention and involvement with families, occupying a great deal of social workers’ time?

What is your view on that and what, if anything, should be done about that? Mr Charters: Clearly, if an intervention proves not to be effective or helpful for the child, 1235

predominantly, then we would need to look at why these issues were being raised through Social Services and what was the reasoning for that, and then address those reasons.

Q73. The Speaker: Okay. Do social workers, in your view, have the time to turn families around if they are involved 1240

with a lot of low level interventions and referrals that prove groundless? Mr Charters: Again, like other services, it is going to be how we put pathways together that

enable perhaps earlier or lower level intervention to be not just a social work task but a multi-agency offer. 1245

So where families are looking for help and needing help and indeed children within those families are looking for assistance, it is going to be how we work with Education in the schools, how we work with Health and other community services as well as social work, to enable that appropriate support to be given. But I do accept the point that that also has a knock-on effect of being able to focus our particular child protection resources and social work resources where 1250

they are best placed, which is in those cases where their services are needed. Q74. The Speaker: Yes, because you will be aware of the Haringey case where child

protection information was raised inappropriately by social workers with other agencies and, of course, the whole thing went to court because they were acting ultra vires. We do not want that 1255

happening here, do we? Mr Charters: I refer to my previous answer which was: absolutely, there needs to be robust

data protection arrangements in place that ensure that proper processes –

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Q75. The Speaker: Yes, in compliance with the law and what we are interested in is child 1260

protection. Just a final one, Chair. I see on 27th September there is to be a conference at Keyll Darree,

aiming to promote the emotional health and wellbeing of children and young people. Can I just ask what you mean by ‘wellbeing’ and to which statutory duty of the Department does wellbeing relate – children’s wellbeing? 1265

Mr Charters: I can provide information on that for you. I cannot say at the moment what the

local professional definition is of wellbeing, but I am happy to provide that for you. The Speaker: Thank you. 1270

The Caairliagh: Okay. Thank you, Mr Speaker. Mr Crowe. Mr Crowe: No, I have no questions at this stage. 1275

Q76. The Caairliagh: Right, okay. Still staying with social care but, to give Mr Charters a bit of a break, I would like to ask you,

Minister: in June this year, your Department consulted with the childminders on proposed new standards, including a reduction in the number of babies who could be looked after at any one 1280

time – what is going on with that? Has progress been made or where is it at, at the moment? The Minister: We have had consultation; we are in the middle of working out

recommendations on that. Obviously the UK requirements are different than they are in the Isle of Man and we have 1285

tried to adopt a commonsensical approach, so we are looking at ways of… say you have twins, they can be looked after by the same childminder rather than having to split them; the same with triplets.

If you just bear with me a second, I will get my notes on this. The new standards will provide clear information to child daycare providers on what is 1290

required from them and will provide clear information to parents about what services will be expected to provide.

The context is the Regulation of Care Act 2013. Childminders have a legal obligation to ensure they provide a service that meets the Regulation of Care Act. Consideration was given to there being a public consultation but it was decided that, as the only major policy change affected 1295

childminders, that was unnecessary and we went to childminders. Childminders were sent individual copies of the draft standards, asked for comments and

met ahead of registration and inspection in July to share their views which were considered along with written responses. There are 122 registered childminders; 12 of them responded in writing, some of whom contacted their political representatives, primarily about the 1300

Department’s intention to limit the numbers of babies under 12 months to one at any one time. Such proposals have been adopted in other jurisdictions and worked effectively and safely.

This proposal is not just a safety issue, it is also providing quality of care that will help a baby thrive, form secondary attachment bonds and feel safe and secure.

The Department had not been contacted by parents about the draft standards but we are 1305

aware that parents have been given the information by childminders and there has been media interest in care standards.

Consideration of responses from childminders resulted in taking on views and amending certain areas within the standards. Each standard can be flexibly applied according to circumstances. There is no intention to rigidly apply the ratios where there is a definite 1310

continuity of care issue, with satisfactory risk assessments demonstrating that the continuity of

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care for the child/children takes priority, and there may be concessions made within the age ranges permitted.

The revision of standards may be prompted by incidents and omissions that have been identified through routine inspections. These care standards are underpinned by research by 1315

both academic and professionals in the field and practice undertaken by organisations such as the Pre-school Learning Alliance and childminding associations in other jurisdictions.

The fact that childminders have been permitted to care for more than one baby under 12 months is irregular and is out of step with accepted best practice.

1320

Q77. The Caairliagh: In the United Kingdom? (The Minister: Yes.) Yes. So is it not just a case of adopting, again, a United Kingdom policy provision at a time when

we do not actually have a problem with this level of care for babies with childminders? The Minister: It is making sure we ask whether we follow best practice. If we had an incident 1325

and we found that the Isle of Man was miles behind best practice you would have me up in front of here: why hadn’t I followed best practice? So I am damned if I do and damned if I don’t.

However, we have said that where you can clearly show that you can follow the procedures and the standards to make sure that two children… instead of just following religiously the one child under 12 months ratio – for twins, triplets etc – as long as you can prove that you can 1330

adequately do that, then it could be said that we are deviating from religiously following UK standards.

Q78. The Caairliagh: That is completely new, is it, Minister, from when you first launched this

consultation, in that it was said in the documentation then that if a childminder was in the 1335

position where they and the parents wanted them to mind twins or triplets, then an exception could be made if there was a family connection; but if there is no family connection then it sounds as though it is still going to be strictly to one baby under the age of 12 months?

The Minister: I think that will be the mainstream, but if a case is made the discretion is out 1340

there, subject to satisfactory risk assessments. So we have to be seen to be following best advice really and the latest thinking in standards. As I say, you are damned if you do, damned if you don’t.

Q79. The Caairliagh: Yes, so it will be interesting though, I think, for the Department, 1345

wouldn’t it, before just following best practice of the United Kingdom – which is not the Isle of Man – to actually do some sort of impact assessment? Because we are hearing anecdotal evidence that some young mums will no longer be able to place their baby in the hands of the childminder, because the childminder is restricted to one under the age of 12 months; they cannot afford the other private nursery costs and therefore they are going to be in a very 1350

difficult situation, trying to hold down a part-time job, for example. So it will or could impact negatively on society.

The Minister: It could, Madam Chairman, but I think, I have not got it with me but I am more

than happy to send you the initial thoughts and then what we have done as a result – the 1355

amendments we have made as a result of the consultation. We have listened to the feedback we have had from the childminders, we have made

amendments based on their comments and I am more than happy to have a copy of that sent to you for your perusal.

1360

Q80. The Caairliagh: Thank you very much for that.

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Again for the Minister – and please feel free to help yourself to water; it is actually very warm in here – in 2012, the Department of Education and Children withdrew its pre-school provision, in favour of an outsourced model.

This year, on 20th May, Tynwald debated the report that this Committee made on the 1365

investigation of the issue. As part of that debate, Tynwald agreed, and I quote: ‘That the Department of Education and Children [would] work with the Department of Health and Social Care to consider regulation and other means which will maximise the educational standards applicable where pre-school establishments enjoy the benefit of public funding through the credit scheme.’ 1370

That was approved. My question, Minister, is what have you done about it? The Minister: I would have to give you an answer on that. I have not got a prepared

document on that. 1375

Q81. The Caairliagh: Okay, but in essence what we were saying – which was approved – is

that the two Departments should get together to consider regulation – in other words, legislative provision – to ensure that there was something in law to monitor and measure the educational standards being delivered in these establishments where youngsters are going, 1380

which are receiving Government funding since its privatisation. The Minister: Right and, in the legislation I have got at the moment in front of me, it does not

appear that an Act is in the offing at the moment, but I would have to check with the officers to see whether they have been meeting with the Department of Education. 1385

Q82. The Caairliagh: We have asked the Department of Education a similar question and they

too floundered in answering, so now we have asked both of you it is hoped that, if it is not featured anywhere within legislative provision going forward, it might still be able to be entered into some kind of legislative framework before the opportunity is left too late and this 1390

administration goes out. If you could follow it up, Minister? (The Minister: Yes, certainly.) Yes, please.

Last month the Treasury Minister announced the reintroduction of personal capability assessments for the Isle of Man, for residents who receive incapacity benefits. This is following the initial pilot study which was undertaken by Atos – a highly controversial organisation – and 1395

subject to court cases, following their initial findings and assessment of people being deemed to be fit for work.

What is the impact of this initiative on Social Care? Previously, in the previous Department, it was a responsibility of Social Care. It has only just recently moved as a responsibility now to Treasury, but what sort of impact will this initiative have on yourselves? 1400

The Minister: I cannot really comment on that. It is no longer a part of the Department of

Social Care. I know at the start you mentioned Social Security as part of my remit, but it was for a very short period of time when I ran two Departments, but now that is part of the Treasury’s remit, so that is something that you have not factored… 1405

Q83. The Caairliagh: Surely, as the Department of Social Care, you must have input into this

type of thing coming in, which will impact upon the individual who might revert back to Social Care for some help and support?

1410

The Minister: I will certainly ask my officers to see who is dealing with this. Obviously, my Department is massive and I could not know every angle but I will certainly ask them to see what is being worked on.

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Q84. The Caairliagh: No, well it is happening. It is unfortunate that Treasury used the word 1415

‘enforce’ – that Treasury was going to enforce these capability assessments; a rather unfortunate wording and I feel sure Social Care would not have used similar wording had it still been under your remit.

Anything further, Mr Speaker or Mr Crowe, on this before we move off? 1420

The Speaker: On social care, if I may just ask a final question? (The Caairliagh: Yes.) Just picking up a final point for Mr Charters, I notice from the Community Care magazine, of

September last year, that in order to build a new strategy – which you talked about joining the dots between existing services, Police, Social Care, schools etc – that you were rolling out a scheme of relationship managers in Bexley and I just wondered whether you thought that they 1425

were needed in a place like the Isle of Man? I know we did touch on this issue a few minutes ago. Are they needed in the Isle of Man in a

small community like this – relationship managers? Mr Charters: The term ‘relationship managers’ was not the title of the role that we ended up 1430

using, but a description of the function. The key strategy that we had in Bexley – and I think the human need is the same – has

variations, dependent on the culture. There is a cultural difference here on the Isle of Man but, fundamentally, the problems that I referred to earlier, that stress individuals and families, are very much the same. 1435

We talked about economic stress, environmental and psychological stresses that we all face and, for some families and individuals, they struggle to meet those challenges. Making sure that there are, particularly families… one of the key and all the research shows – not just in the UK but a cross-range of communities – that children are very often the first elements of a family to exhibit symptoms of that stress, and non-school attendance is very much one of the first pieces 1440

of evidence that indicate that there are difficulties in place around a family and within a family. This prevention strategy which was part of the key driving element of the thriving community

service that we put in place in Bexley, was about saying when working with Education, working with other agencies, when some of the symptoms arise that there is a resource made available – again, very much at the behest and control of the individual family and the individuals within it 1445

to seek and be provided with support, with someone who can stand alongside them and with them, and then liaise with a range of different agencies to provide them with the support that they need.

At a time of high stress, navigating through public service arrangements to get the right support is invariably difficult and invariably does not happen. Then that leads to the needs 1450

escalating and getting higher and higher, which they do not want – individuals do not want – we do not want and costs the public purse a lot of money.

So that prevention agenda is real, both in terms of for the individual and for public services; and if we can prevent escalation of need by earlier intervention, by having a front door to public services that enables the appropriate and the right support, very much with the individual family 1455

members involved in that and being in control of that, but someone who can stand alongside them and make sure and enable public services to work in an integrated way around the needs of that individual and family, is something that I believe that actually most of us, most people, wherever they are living, when they are in that kind of stress would want available.

1460

Q85. The Speaker: Thank you. I come back again to the threshold for triggering an early intervention. If we are not careful, early interventions can not only cause a lot of work for social workers who are distracted from genuine child protection issues, but it can be extremely traumatic for the family where it is an unwanted early intervention – a needless referral.

How do you avoid that if you are having a blanket policy like this? 1465

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Mr Charters: I completely agree. It is not a blanket policy. I would say it is a service that is available for individuals to be able to access. That is why I did not say a social worker, I said a relationship manager; someone who is not a state agent in that sense, because that very often puts people off – whether you are a social worker, a nurse, a policeman, invariably there to 1470

discharge a function and ‘do to’. This is about having a resource available for a family member or a family who has identified

that there is a need, who needs help and needs to access that help very quickly. Invariably I would say it was not a social worker that was doing that work. It is someone who can get alongside a difficult situation and help that individual to get the support that they need. 1475

The Speaker: By involving other agencies (Mr Charters: Whatever they need.) in their

destiny. Mr Charters: Whatever we provide as a public service – not just social work but if education 1480

is needed, if support is needed, if a community centre will work, engaging the voluntary sector; making sure that perhaps informal support that may be available locally… that they are aware of that information. Not that they do it for them, not that they are in control of that – very much the opposite. The individual has to be in control, absolutely.

1485

Q86. The Speaker: And, of course, acting within the law and the legal framework. We are not talking about anything like the Named Person policy in Scotland at the present

time, are we, under the Getting it Right for Every Child agenda? You will be familiar with that, are you?

1490

Mr Charters: I am not. Q87. The Speaker: No. The ‘Named Person’ in Scotland is somebody given statutory recognition – it might be a

headteacher or it might be somebody else – who is responsible for that family, for doing the sort 1495

of thing you are talking about; but that is the subject of a legal challenge at the present time, as being non-compliant with the European Convention on Human Rights – interference in family life.

We want to avoid that, don’t we? 1500

Mr Charters: I will say again, I am not about creating a service that is in control of other people’s lives. I am about enabling access to support and help and services and intervention, when the individual chooses that that is what they want and that is what they need.

The Speaker: Thank you very much. 1505

Q88. The Caairliagh: Thank you. Minister, on 15th July this year in Tynwald Court, you made a statement about the treatment

of age-related macular degeneration. You said: 1510 ‘I have made a promise that I will bring this service to the Island, and this I will do.’

Our question today is: when? The Minister: The beginning of next year. 1515

The Caairliagh: The beginning of next year?

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The Minister: Well, when I say the beginning of next year, I gave a commitment to deliver it early in 2015 and I am glad to say that we are on line to deliver that service. In fact, as we speak, 1520

I am missing a meeting with Aintree, who are on the Island, who provide the service, so I can attend this meeting.

The Caairliagh: Well, one has to get one’s priorities right. 1525

The Minister: One does, indeed, Madam Chairman. (Laughter) The Caairliagh: So when you say early next year, are we looking at the first quarter or the

(The Minister: Yes.) first half? 1530

The Minister: The first quarter. The Caairliagh: The first quarter. Good. Have you got a question on this, Mr Speaker? 1535

Q89. The Speaker: It is just are you in a position to advise: does that involve the alternative strategies that you are aligned with outside providers coming to the Isle of Man to deliver the service or have you got the actual options finalised yet?

The Minister: I have to be careful because we are in the middle of the financial negotiations 1540

here – The Speaker: Yes, I shall not press you on that. The Minister: – but I will be bringing a team of people to provide the service on the Island. I 1545

will not be employing people full time to do the service on the Island. They will be coming to the Island to deliver that service.

The Speaker: Okay. That is fine. Thank you. 1550

The Caairliagh: Thank you, Minister. You will be – Mr Crowe: Can I just ask – 1555

The Caairliagh: Sorry, Mr Crowe. Q90. Mr Crowe: Are budgetary constraints holding you up in any way on the macular

degeneration… ? 1560

The Minister: Facilities, contracts, getting the right people to do it; there is so much to take on board when you say you are going to do something. That is why, unless I know I can deliver or at least I am confident I can, I do not say something.

It has taken an amazing amount of work behind the scenes to get this done, to get value for money for the taxpayer, to get a better service for the people who have had to travel, to join it 1565

up, to see that we have the facilities to plan where it is going to be held to... You have to have a short-term approach. We will do this in the short term, but in the long term it may be totally different.

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So there are so many levels that we have had to work at to deliver this service, but I intend to deliver it in the first quarter of next year and I am hopeful that I will be making a financial saving 1570

as a result of that, on top of giving a far better service for all of our constituents. I cannot think of anything worse than one of my constituents, 85, who has to get up at 4 a.m.

or 5 a.m. in the morning to go on a red eye flight, if you pardon the pun, to then have to go to Aintree to have an injection. I made it a priority as a backbencher and I fought for it and I made a promise to the House that I would deliver. 1575

Mr Crowe: Thank you. Q91. The Caairliagh: That leads me nicely into my next question which is about an Internal

Audit report. This is the one about the cost improvement programme. On all Internal Audit 1580

reports your name is featured, Minister, together with the Chief Executive and senior officers, of having received copies.

I wonder, have you read this one? This is about the Cost Improvement Programme, which is a new initiative undertaken by Internal Audit, where they are assessing right across Government on their cost improvement programmes. 1585

We have to say we were quite concerned that your Department falls very short of the target. The Minister: That is why we are making large changes in the Department as a whole. We

know there are improvements to be made. That is why we are bringing in relevant people. I do not know if Mr Charters has any information on that individual report. We are 1590

commissioning our own ones. Value for money is something I feel we can deliver and savings that we can then plough back

in to improve our service to the people of the Isle of Man; but it is absolutely vital that we get the right team in place first at the top, get the proper procedures in place, get everyone working together and then I am convinced that we will go from having bad reports on value for money 1595

to, hopefully, top of the pile. The Caairliagh: We hope you are right because the budget is in excess of £150 million per

year, which is considerable. 1600

The Minister: Yes, it is £184.5 million for the entire Department, net, and £240 million, gross. The Caairliagh: Okay. We have picked up in that, obviously, Mr Charters has had input into

the management comment, in terms of the recommendations made, which talks about the vision, the new strategy coming in and developing all of that; much of which is due to come in, in 1605

fact, this month and some of it in December. So probably what we will do, as the Committee, because we are quite concerned about some

of the language used in here from Internal Audit, is we will probably follow up early in the new year – certainly post-December this year – to find out whether or not the improvements that have been recommended have been pursued and what is happening there; because a lot of it is 1610

ongoing, some of it comes in. So we will follow that up. It is talking also about committee board structure and the representatives on that,

measurement of performance and delivery, and a group that is chaired currently by a political Member, with representatives from Health Services along with Mental Health and Community Health. This needs to be reviewed. It sounds like some rather brave, bold moves are going to be 1615

made in terms of restructuring things in order to come up with a good report next year. The second Internal Audit report – Q92. The Speaker: Just before you go on to that, (The Caairliagh: Yes, Mr Speaker.) one of

the items referred to, I think, is a long-standing problem – the Department’s cost analysis 1620

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information – and I think, Minister, that something that you were very vocal about before coming into the Department… actually knowing the costs of doing the work and it is not a new problem.

The report does go on to say it is expected to take over two years before benefits will be realised. I assume that is in terms of the IT systems – 1625

The Minister: The IT systems. They will be able to talk online and talk together – from a

computer IT system point of view, I think – with the UK, so that we can do proper benchmarking. (The Speaker: Yes.) But I started that before Mr Charters even came, as a priority.

We are putting an awful lot of things in place now, which we will not see the benefits of for a 1630

couple of years, but that should help me give a significant saving. Costings are something I have given in a Budget speech, as the belief that a Department that spends as much as we do must know what its costs are if it is going to… We could be doing fantastically well; we could be doing dreadfully. We have to get to know that.

1635

Q93. The Speaker: I would just be interested in the extent to which Mrs Morris and Mr Charters, from seeing this deficiency in the Isle of Man system, in terms of information cost analysis which will enable robust accounting to take place… how much of a priority you see that to be as the key to a lot of other things happening?

1640

Mrs Morris: From my perspective, it is a high priority. Certainly in a previous life in the UK NHS I was used to seeing cost per service line broken down etc – something called service-line management. So I know that that is something that takes a lot of time to build and it takes a lot of education for the people working within the whole health community. So, for instance, the budget holders in the divisions need to learn how to understand the budgets in a different way. 1645

So it is something that we would want to build upon, but it is not something that could happen quickly and, in my experience, when we introduced it in Newham it took probably two years to get to a point of proper understanding and that was shared understanding with clinical directors, divisional managers, executives – everybody – non-executives, directors in the board structure and so forth. 1650

It is something that takes time and confidence to be built in that arena. The Speaker: Okay. That is fine. Thank you. Q94. Mr Crowe: Can I just ask a question (The Caairliagh: Yes, Mr Crowe.) of Mrs Morris? 1655

It appears from Beamans that the financial responsibilities were moved from the Department finance director to the Hospital and there will be a management accountant who will be responsible for the cost savings in the Hospital. Is that correct?

Mrs Morris: I understand, certainly, that… I believe there are interviews planned in October 1660

for a management accountant to join the Hospital team. They will still be managed by the finance director. I believe that they will be positioned in the Hospital team and they will obviously have… the health team, anyway; not just the Hospital team but the health team. I believe there are two people coming on board, hopefully, after interviews – one potentially for Health and one potentially for Social Care. That is my understanding currently, but they are not 1665

yet in post. Q95. Mr Crowe: This would be a change from the Department having responsibility, to the

divisions having responsibility? 1670

Mr Charters: No, it is still very much the Department’s responsibility. We are not changing that.

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What we are trying to do is, in reflection of what has just been said, strengthening the financial management arrangements across Health and Social Care and, equally, there is a focusing of an HR support role, both again in Health and in Social Care. 1675

The Minister: If I may, Madam Chair, to answer, a few months before Mr Charters started,

Mr Colin Kniveton and myself – who was the interim Chief Executive – took a visit to a private hospital in Dublin where we spent a very interesting day looking at their costing provisions, along with other things, to see how they ran their setup. 1680

They had five orthopaedic surgeons and those five met every month where each individual cost of every individual operation was itemised, down to the nearest swab. They then compared return rates, problems, complaints etc and ran a really tight, slick ship.

That is the sort of financial information I want us to have on the Island; but, as has been said before, I am trying to get over to people time and time again, I cannot do this overnight. It is 1685

going to take me two to three years to get things in place that I think we should have. Q96. The Caairliagh: May I ask at this point, Minister, had the contractual arrangements that

the Hospital have with the consultants, in terms of the extent of private work that they can do in any one year… have those contracts changed in any way during the last five years or are they the 1690

same? The Minister: I cannot give you the answer on whether they have changed in the last five

years. I know we are constantly… With a new broom we will be reviewing everything for improvement. 1695

Q97. The Caairliagh: May we make a suggestion that when you do have time perhaps when

you are looking at benchmarking and you are looking at a nice, tight, slick ship, such as you saw in Dublin, there might be a lot of potential for making some savings if everything is properly recorded and accounted for. 1700

One of the areas that might be fruitful is looking at the current arrangement with the consultants. The last time it was looked at the consultant coming into the Island had an arrangement with management, where they would report to them at the end of a 12-month period with what private work they had done and there appeared to be no measurement of that. 1705

The only thing that appeared to be measured was the NHS work and that was negotiated at the beginning of the 12-month period. So perhaps that might be looked… It may well have changed, Minister, but it might be an area that might be fruitful for you.

The Minister: I am more than happy to and I thank you for that. 1710

Q98. The Caairliagh: The last Internal Audit report that we have received is about the stocks

and store keeping at Noble’s Hospital. I would imagine that one, if not all three of you, will have looked at that. This is the one that

has photographs attached to it. Have you seen it? 1715

The Minister: I have, indeed. Q99. The Caairliagh: You have? (The Minister: Yes.) Yes. What progress – ? 1720

The Minister: It is not the worst thing I have seen. (The Caairliagh: Sorry?) It is not the worst thing I have seen.

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The Caairliagh: I am sure. No, probably not, but there again, given your keenness to stop all the leaks – 1725

The Minister: I have seen it and work is underway to dramatically improve it. Q100. The Caairliagh: That is good. Right. Dramatically improve it in a short space of time,

hopefully. 1730

My final question – other than the Members may have further – to the Minister is how have you allocated responsibility to your departmental Members? Do they have formal delegated responsibility in writing? (The Minister: Yes.) To whom does the administration then report?

In other words, if you have got your divisions… You have the divisions headed up by a political Member who chairs. How is that information then fed back to the centre, being yourself 1735

and the Chief Executive, and vis-à-vis the other way around? The Minister: Yes, I do delegate. Mr Cannan, until yesterday, had delegation for Housing and

Children’s Services. He now has Children’s Services and I have taken on Housing for the time being. 1740

Mr David Quirk MHK has Adult Services. Mr Michael Coleman has Mental Health. Mr Dudley Butt MLC works with me in the Health Service and he is in charge of chairing various departments on the running of the committees on cancer funds etc.

Q101. The Caairliagh: So how do they feed back? 1745

The Minister: We have our monthly departmental meetings, obviously, where everyone gives

a report of what they are doing in various areas. Obviously, if there are any problems in between then I am in the office five days a week, so they will come and see me over various meetings. Obviously, the officers will report back to the Chief Executive what is going on. 1750

Q102. The Caairliagh: It is just that, with you bringing in a whole new leadership team in the

Department… and you made the comment, I think, earlier on about – the words escape me now but something about – a career civil servant. You made a comment earlier.

1755

The Minister: Yes, I made a comment that we have fully-qualified people, who specialise in the area of health and social care, at the top. That has not always been the case (The Caairliagh: Okay.) and I think in some areas someone who has no experience can handle certain departments and do a very good job, but I think when you are in such a specialist area as health and social care you really need people… 1760

I would argue with you that the grilling you have given my Chief Executive on children’s services… would you have been able to have the detailed arguments back off previous people in the position of the CEO of the Department? I would like to say you would not have got that.

I think it is really important with the specialisation of health and social care – 1765

The Caairliagh: I am surprised, Minister, that you think we have given him a grilling this afternoon! (Laughter) I thought we had been very gentle actually.

The Speaker: Light touch! (Laughter) 1770

Q103. The Caairliagh: Really what I am trying to get to the nub of, Minister, is that you have professionals now coming in, taking up the position that was previously a civil servant, perhaps without a particular expertise or skill in that area; and then you had the layer of the politicians with their delegated responsibility and at the top is you as the Minister.

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I am just wondering… the civil servants know about dealing with the political interface and 1775

how to communicate with their political ‘masters’, (The Minister: Yes.) which might be the Member with delegated responsibility somewhere before the Minister, because the Minister has delegated him or her with a degree of power.

We are bringing professionals in. Is there a gap, perhaps, with the political interface now? (The Minister: No.) Is that something you are going to have to work on? 1780

The Minister: It was one of the questions in their interviews: what was their experience of

dealing with a political level, introducing legislation etc. So everyone who has been interviewed and offered jobs fill that criteria. They had experience working at political level.

1785

Q104. The Caairliagh: So you do not envisage there being any problems? The Minister: No, but I also have some very good civil servants in the Department to help.

Obviously, there are going to be differences in the areas where people have come from to the Isle of Man and I have a good team behind me who will explain the differences that we have on 1790

the Island, compared to maybe what they have been used to in the past. The Caairliagh: Mr Speaker, do you have any further questions? The Speaker: Not at this stage. Thank you. 1795

The Caairliagh: No, because I am with a view to closing. The Speaker: Thank you. 1800

The Caairliagh: Okay. Mr Crowe. Q105. Mr Crowe: Can I just ask one question? All of these changes that you are making to Health and Social Care will cost a lot of money.

Have Treasury agreed a special budget head for the change or is it part of your general 1805

negotiations with Treasury over next year’s budget? The Minister: All of the people who have left the Department have gone under approved

schemes. So these are standard schemes. There has been no – 1810

Q106. Mr Crowe: No, I do not mean people. I mean the whole changes that you bring in for Health.

The Minister: The changes that I am bringing in are going to save money. They are not going

to require additional funding to do, on the whole and, obviously, if there is anything found that 1815

we want to do extra, where additional funds will be required, we will go to Treasury and to Tynwald if necessary. But, no, a lot of the work that we are doing I would hope these initiatives will (a) improve the service and (b) give greater value for money so that we can then plough that money back into improving the service.

1820

Q107. Mr Crowe: You have had your meetings with Treasury to agree next year’s budget, have you?

The Caairliagh: We have not had the final one. We have had provisional meetings. 1825

Mr Crowe: Right. Thank you.

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Q108. The Caairliagh: Minister, just for clarification really, Mr Speaker has just reminded me that to improve Noble’s Hospital there was an estimated cost of around £2 million.

The Minister: Yes, sorry, if you meant in relation to a fund being set aside. (Mr Crowe: Yes.) 1830

Sorry, yes. We have had various business cases put to us from Noble’s and at the moment we are going through the priorities that are going to deliver the best improvements that relate to the report and we will be going to Treasury to unlock that amount of money to deliver.

I have various announcements – 1835

The Caairliagh: That is if you have the key. The Minister: That is if we have the key. We have various announcements to make over the coming months on initiatives. 1840

The Caairliagh: Mr King, is there anything that we have not covered? The Clerk: No. (The Caairliagh: No.) Thank you. The Caairliagh: Okay. 1845

It just remains then for me to thank all three of you very much for coming in today to our first session with the new Department. There will be many more, I have to warn you, but we try to be fair and balanced and, obviously, we have to issue reports on occasion to Tynwald Court about our feelings about what we have heard or outcomes.

Also, of course, we often suggest improvements, especially within statutory provision. That is 1850

something we are very keen on – that Departments have the vires to do what they want to do; and if they have not got the vires woe betide you because this Committee will pick up on it very quickly.

So, with that, I hope you enjoy your time in the Isle of Man and you deliver all of your vision and aspiration and to you too, Minister. Thank you very much. 1855

Mr Crowe: Thank you very much. The Speaker: Thank you very much. 1860

The Caairliagh: This session is now closed. Thank you.

The Committee adjourned at 4.58 p.m.

105105

106106

31st March 2015 House of Keys Oral

Question: What policy options have

been (a) considered and (b) agreed in

respect of means testing?

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HOUSE OF KEYS, TUESDAY, 31st MARCH 2015

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TREASURY

1.4. Means testing – Policy options

The Hon. Member for Douglas West (Mr Thomas) to ask the Minister for the Treasury:

What policy options have been (a) considered and (b) agreed in respect of means testing? The Speaker: Question 4. Hon. Member for Douglas West, Mr Thomas. Mr Thomas: Thank you, Mr Speaker. I beg leave to ask the Minister for the Treasury what policy options have been considered and 55

agreed in respect of means testing. The Speaker: I call on the Minister for the Treasury, the Hon. Member, Mr Teare. The Minister for the Treasury (Mr Teare): Thank you, Mr Speaker. 60

In answer to the Hon. Member’s part (a), consideration has been given to means testing in other countries and we have reviewed the following options: (1) implement in isolation, driven by one Department focusing on one service, which takes no account of the effects on individuals and households; (2) implement a central means-testing system on a phased basis with corporate rather than departmental oversight. 65

Mr Speaker, in answer to part (b) of the Question, Council accepts that there should be a corporate policy for a single, fair and consistent means-testing regime.

Thank you, sir. The Speaker: Mr Thomas, a supplementary. 70

Mr Thomas: Thank you, Mr Speaker, and to the Treasury Minister for that helpful Answer. Were the two options described by the Treasury Minister those which were agreed at the

Council of Ministers at the end of January and as described in the Agenda for Change? 75

The Speaker: Treasury Minister to reply. The Minister: These have been agreed by the Council of Ministers as the way forward, and

the actual policy is being determined by the Social Policy and Children’s Committee, which will be responsible for means testing policy. Treasury will be responsible for the operation or the 80

implementation of that policy. The Speaker: Hon. Member for Douglas East, Mrs Cannell. Mrs Cannell: Thank you, Mr Speaker. 85

Would the Hon. Minister do the courtesy of sharing that information with Tynwald’s Scrutiny Committee on policy and social affairs? Because it is an emerging policy and if you want to get it right then you need to get the right people involved in giving it the necessary scrutiny.

Secondly, can I ask him: is he aware that in fact there are problems with the means testing of the Child Benefit, in that what is happening is that Treasury are taking into account a couple’s 90

earnings from the previous year, and in the case of a young family who have just had a child this year they are now being billed for something like £3,000 or £4,000, in some cases, to be paid this year at a time when they have got a new baby to look after and their income is cut in half? Is

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that fair to actually take the previous year’s earnings into account before billing on the means testing of Child Benefit? 95

The Speaker: Treasury Minister. The Minister: In response to the second part of the question, yes, I am aware of the

circumstances – I think that individual wrote to all Members of the House of Keys – and I have 100

started a review of that, and I do not think it right to talk about an individual case. (A Member: Hear, hear.)

She asked whether we should share the information with the Policy Committee, and yes, if the Policy Committee would like to make an approach I am sure that that information will be made available. 105

The Speaker: Hon. Member for Onchan, Mr Quirk. Mr Quirk: Thank you, Mr Speaker. Can I ask the Treasury Minister, in reference to means testing and housing, can the Minister 110

indicate how we have progressed down that particular road? The Speaker: Treasury Minister. The Minister: The means testing on housing in effect is similar to all other forms of means 115

testing, sir. It needs to be proportionate and cost effective. We are still actually reviewing that but it is all in the overall review of means testing per se.

The actual policy dealing with means testing, or the principles of means testing, were set out by the National Audit Office in the UK and one of them says that we should have a look at how means testing actually takes effect and the cumulative effect on different parts of the 120

community. Also, we need to have a look and make sure that it is fairly simple of design, fair in use, but also that the costs do not outweigh the benefits.

The Speaker: Mr Thomas, a supplementary. 125

Mr Thomas: Thank you, Mr Speaker. Can the Treasury Minister, especially in the light of his most recent comment just then about

the costs of means testing, agree to share with Members the actual costs of developing systems and administering systems for means testing in relation to Child Benefit?

Moreover, can the Minister advise whether or not the Cabinet Office has a role in this means 130

testing project? Because in recent weeks the Treasury Minister has actually indicated that some functions were delegated to the Cabinet Office in this area.

The Speaker: Mr Teare. 135

The Minister: The Hon. Member will be aware from my earlier comments that I said the policy is being driven by the Social Policy Committee, so there is no change there.

He did ask as to the cost of means testing for Child Benefit. The Hon. Member will remember that this was done and was set up to be very simple to administer. So, in other words, it is using data which is currently held by the Income Tax department, historical data, and there is a 140

gateway between the Income Tax department and the Social Security section. That gateway was agreed by Tynwald to in effect make sure that we have the information and it is available to us. So it has been done as a fairly simple system – simple to operate and cheap to operate as well.

The Speaker: The Hon. Member for Onchan, Mr Karran. 145

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Mr Karran: Vainstyr Loayreyder, would the Shirveishagh Tashtee not agree that, allowing for the fact that we are a low tax area, that means that only the well-off benefit as far as taxation is concerned? When are we going to see means testing as far as those who are struggling with the problems of expensive housing and all the other costs of living that this administration and the previous administration have inflicted on the people of the Isle of Man? When are we going to 150

see means testing, so that instead of trying to hit the legitimate ones who are just above Social Security, we are going to see a situation where you are going to actually start doing some means testing for those who have a benefit from living in a low tax area instead of those that do not have that benefit?

Could I also ask the Shirveishagh Tashtee, as far as his proposals as far as taking a load of the 155

low paid out of the tax system is concerned so we do not have that diatribe, that we do not end up with a situation where a lot of people are going to actually be worse off who are just above that proposal, which is just really what many outside this Hon. House see as a complete and utter charade?

160

The Speaker: Treasury Minister. The Minister: I would not say it is a charade to attempt to take 10,000 out of the tax net. I

would say that is very accurate targeting of very limited resources. So I think that is a good step. However, I do agree that in respect of means testing there should be a taper effect. I have 165

always been concerned with the cliff-edge effect, that if you are £1 on the right side then you get the full benefit, and if you are £1 on the wrong side then you get no benefit. So I think that, as part of the means testing policy as a whole, I would be strongly in favour of having taper effects.

170

The Speaker: A final supplementary. Hon. Member, Mr Thomas. Mr Thomas: Thank you, Mr Speaker. Pursuant to my earlier question, will the Treasury Minister circulate the annual running costs

and the actual development costs for the very simple effective data-sharing based system for 175

Child Benefit means testing? The Speaker: Mr Teare. The Minister: I cannot see the point in putting more costs on top of costs. 180

1.5. Investment manager returns – Commercial confidentiality

The Hon. Member for Douglas West (Mr Thomas) to ask the Minister for the Treasury:

Pursuant to his Answer in March Tynwald, why the relative, risk-adjusted and attributed returns of Government’s investment managers are subject to commercial confidentiality?

The Speaker: Question 5. The Hon. Member, Mr Thomas.

Mr Thomas: Thank you, Mr Speaker. I would like to ask the Minister for the Treasury, pursuant to his Answer in March Tynwald,

why the relative, risk-adjusted and attributed returns of Government’s investment managers are 185

subject to commercial confidentiality.

111111

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15th October 2015 Evidence of Hon. T

M Crookall MLC, Minister, and Prof.

R Barr, Chief Executive Officer,

Department of Education and

Chi drenl

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O F






D A A L T Y N


DEPARTMENT OF EDUCATION AND CHILDREN

HANSARD

Douglas, Thursday, 15th October 2015

PP2015/0141 SAPRC-EC, No. 1/15-16

All published Official Reports can be found on the Tynwald website:

www.tynwald.org.im/business/hansard

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STANDING COMMITTEE, THURSDAY, 15th OCTOBER 2015

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Members Present: Acting Chairman: Hon. S C Rodan SHK

Mr D C Cretney MLC

Clerk:

Mr J D C King


EVIDENCE OF Hon. T M Crookall MLC, Minister, and Prof. R Barr, Chief Executive Officer, Department of Education and Children ........................................................................................... 3

The Committee sat in private at 4.02 p.m. .................................................................................... 26

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Department of Education and Children



[MR SPEAKER in the Chair]

Procedural

The Acting Chairman (Mr Speaker): Good afternoon and may I welcome everyone to this public meeting of the Social Affairs Policy Review Committee which is a Standing Committee of Tynwald.

I am Steve Rodan, Acting Chairman of the Committee and with me is Mr David Cretney MLC. Could I ask everyone to please ensure mobile phones are on silent so that there is no 5

interference with proceedings. The Social Affairs Policy Review Committee is one of three Standing Committees of Tynwald

established in October 2011 with a wide scrutiny remit. This Committee has three Departments to cover – Education and Children, Health and Social Care and Home Affairs.

Today’s session is the fourth of our annual general oral evidence sessions with the 10

Department of Education and Children. Our last such session was on 25th June 2014. On that occasion we welcomed Mr Crookall as Minister and, for the first time, his Chief Executive, Prof. Barr.

Gentlemen, welcome again and thank you for coming here before the Committee.

EVIDENCE OF Hon. T M Crookall MLC, Minister, and Prof. R Barr, Chief Executive Officer,


Q1. The Acting Chairman: Could I begin by referring to the June 2014 internal audit which 15

was an exercise being applied across the whole of Government in relation to cost improvement programmes, and your Department, Minister, was the subject of an appraisal in June 2014 which did indicate that there was some way to go in developing full programmes to implement cost improvements.

I suppose, basically, we would like to start the topic by asking whether the recommendations 20

in that report have been implemented. We have been noting the action plan as giving certain dates in late 2014 and also this current year, 2015, as target dates for implementation. One example being the development of a target operating model which prioritised objectives in terms of cost reduction and service delivery to be in place by March of this year.

I wonder if you and the Chief Executive could give us, please, a progress report. 25

The Minister for Education and Children (Mr Crookall): Yes, thank you, Chairman.

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Obviously, it is an ongoing programme and, going by next year’s budget, that will continue to be an ongoing programme. We have got plans and targets which we have to deliver. It is very tight. We have got a lot of issues that we are looking at and will continue to look at, whether 30

that be with a view to being able to afford what comes forward in pay rises and covering the pensions and all sorts of things, but at the end of the day we need to be able to deliver a first class education system without losing those at the coalface; and that is our intention to do that without losing those important people and trying to deliver that by making the changes in the background. 35

We think we have been able to do that so far. Our figures would probably clarify that, but it is an ongoing programme.

Q2. The Chairman: So have you developed a target operating model? 40

Prof. Barr: Yes, I can confirm, Chair, that we have actually developed a target operating model and the model will, in fact, detail the Department’s areas of spend, along with financial pressures over the next five years; and that will include modelling pay awards of between 1% and 2%, pension contribution increases, expected inflation rates, areas of demand-led growth in terms of where we anticipate levels of child entry into school and also other areas and pressures 45

which we look at in terms of income growth and other contributory factors that would put pressure on our service.

That model is now being aligned with the new medium-term financial strategy. As you are probably aware, Chair, Treasury has decided to adopt a medium-term financial strategy. That is something that Sheila Lowe, the Chief Financial Officer and Treasury Minister have been 50

progressing recently and so we are now aligning our target operating model to reflect that mid-term, medium-term, financial strategy.

Q3. The Chairman: Because there was some comment in the report about short-term

reaction by the Department to cost saving, rather than the long-term view. 55

The report did acknowledge that you had made approximately £5 million savings in the previous four years and had absorbed pay increases and inflationary costs.

Prof. Barr: I would not disagree with that. Obviously, I can only speak for my own

Department, but I think certainly in the early years we were very reactive in terms of how we 60

responded to the budgetary pressures, but of course when you get an annual budget there is the temptation to do that salami slicing, rather than think strategically about the kind of education service that is required across the Island.

We have made a lot of strides in that direction. We are trying to align also future capital spend and future need, in terms of the projections which the Island thinks it might have, so that 65

all of those things are connected in a kind of coherent manner and we have also talked to all of our senior managers across the Department, and all our headteachers, about the financial pressures that the Government is under and the cost improvement expectations that we have to operate under.

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The Chairman: Mr Cretney. Q4. Mr Cretney: Yes, thank you. The Minister referred to salaries and pensions, and there has been some comment elsewhere

in relation to morale within the Education Service in the UK, for example, in fact leading to some 75

people suggesting that they may wish not to remain within the profession. Has there been similar concerns on the Island?

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Prof. Barr: I am not aware of us losing staff because of those issues. As you will appreciate, Mr Cretney, we have a slightly different educational landscape here so things like the demands 80

that Ofsted have put under pressure ... English schools and schools being transformed into academies in England, which is a huge upheaval for schools. We are not living with those pressures so those are additional pressures that they have to deal with in England on top of pay pressures and pension pressures.

I think the biggest issue for us is we are aware that we have asked a lot of our high school 85

teachers to do a lot over the last year and, indeed, through this year and next year, because they are transforming 70% to 80% of the curriculum to the International GCSEs and that is a major curriculum reform.

What we would like to think is that we are only doing that once, so that our teachers ... certainly, we know that it is a lot of work we are asking of them at the moment but hopefully in 90

the medium term it means that we will then be insulated from further changes in England. Mr Cretney: Perhaps for the record, Chairman, I should have pointed out – not that this

question is related but – I have a son-in-law and a daughter both of whom work in secondary education. I should have pointed that out at the start. 95

Q5. The Chairman: Okay. Thank you for that. The report made reference, at the time, to secondary schools being predominantly

autonomous in terms of their delivery, which actually made operating models and directions set by the Department perhaps more limited than they would otherwise be. 100

Could you just indicate how schools’, particularly secondary schools’, Delegated Financial Management (DFM) is working in terms of meeting the Department’s cost improvement targets, given that you do not have direct control; or perhaps you will indicate if, as a Department, you are trying to have more direct control over spending in the secondary schools?

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Prof. Barr: I think, Chair, what I would say there is that shared services have had a massive impact on delegated financial management. So whereas schools had, once, control over caretaking, cleaning, catering, we are in negotiations with DOI over fleet – over buses, schools control ... so in a whole raft of areas where high schools and the Isle of Man College had delegated financial management, those budgets have been taken over by either DOI or by 110

Health; and of course also on the IT side we have GTS who are controlling much of the IT infrastructure.

In effect, the view of our Finance Director, Glen Shimmin, is that DFM is largely dead in the College and in the high schools, because other than books and materials budgets and staffing, which is by and large a commitment that is analysed and is not particularly flexible, there is not 115

really a lot of additional capacity for spending for headteachers or college principals to make those kinds of decisions that they may have done in the past.

Q6. The Chairman: Okay, so the wheel has moved full circle, could we say, over the last 10 or

15 years when it first came in – DFM? 120

The Minister: Yes, very much so and I would have to say that there is now a review across

Government of shared services and how that works, and we look forward to seeing how that review ...

We are not convinced it is working totally. We are doing what we can to make it work, but 125

amongst the schools there are one or two concerns still. But, yes, you are right, as far as DFM is concerned it has nearly gone a full turn, except for a few things that the schools still have control of.

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Q7. The Chairman: Class sizes. Increasing class sizes was a relatively quick and easy way of 130

containing some of the pressures within school in terms of cost. How do they sit currently? Historically, it was always very proudly claimed that average class

sizes were smaller than in England. Is that still the position or no longer the position? Prof. Barr: I think if you were to look at our promotional literature you would see that that 135

claim is no longer there. Q8. The Chairman: Okay. What would be the average class size in a secondary school now? Prof. Barr: That would depend on the subject and there is variation there. In some of our 140

mainstream subjects you would have class sizes of 30. We still have some class sizes which are relatively small.

One of the first changes I made as Chief Executive was to put a stop to very small A-level class sizes. It is a matter of record that we were offering A-level provision at AS-level, with class sizes of threes and twos and fives. 145

From an educational point of view, we did not think that was particularly good in terms of peer learning and it is difficult to see what kind of learning you would get in, say, a drama A-level group with a class size of three, or a politics group where you are talking about discussion and debate really.

So I think it depends on the subject, but we certainly do not now allow schools to have AS-150

level classes of less than eight and that allows them to be more economically viable, but also more educationally robust. But at the other end of the scale we do have, in some cases, class sizes that exceed 30.

Q9. The Chairman: I suppose pupil-teacher ratio would have been a better way of putting it. 155

Prof. Barr: Yes, and I do not have the exact numbers to hand, but if the Committee would like

those I am sure we can present them to you, but they would show that we are no longer ahead of England when it comes to those kinds of ratios.

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Q10. The Chairman: Okay. Just going back to what you just said about the viability of sixth form specialised courses,

does this mean that there has been increasing consolidation in the Island of a centralisation of teaching and learning of sixth-form subjects and travel by pupils from their own school to another school for certain subjects? 165

The Minister: Yes, very much, Chairman. In Douglas, Ballakermeen and St Ninian’s are now working together on their curriculum and

students are working together there from those two schools; and also the three other secondary schools are working together with students travelling from one to the other to make those 170

numbers viable and to give them more options, and it is working very well. Q11. The Chairman: And a sixth form college which was mooted quite some time ago as a

means of addressing this issue – has that been considered at all? Are there any merits in that? 175

The Minister: It certainly has been discussed. In fact, we are in the middle of a combination strategy at the moment and that is a discussion that Prof. Barr has had recently with the secondary heads and it is not a way we believe at the moment would be the way to go.

Certainly, what we have got at the moment with this school sharing seems to be working. It may well be naturally that things progress off from there, but at the moment we would say no to 180

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a sixth form college in the view that you have, which is, I think, just a one-off building where all sixth formers go to. We would say no to that.

Q12. The Chairman: Would the reason be because of the capital requirements actually to get

that on the move or is it a question of resistance and entrenched attitudes on the part of heads 185

of schools? Prof. Barr: I think there are a couple of issues there. It is about the educational provision that

is provided to the Island in its entirety and we would certainly want to ensure that children in the south or the north of the Island got the same educational opportunities, as far as is possible, 190

as young people in Douglas. So I think it is about making sure that is consistent and fair across the Island.

What I think we welcome and what has been a major change, is the willingness now, because the Department has encouraged this, of high schools to work together and the fact, as the Minister has alluded to, that Ballakermeen and St Ninian’s are now doing joint timetabling one 195

day a week on post-16. That is a baby step. I am anticipating that that will move more in that direction and the fact

that the out-of-Douglas schools are working on minority subjects as well, like modern languages and music, to make them educationally worthwhile so that they can still offer them through their schools ... I think the Department’s view is that inevitably somebody outside Douglas may 200

end up doing the bulk of their A-level provision in their own school but may potentially end up doing one A-level in another school or at the College.

We have been encouraging Isle of Man College to ramp up its minority A-level offer and also its re-sit offer in GCSE and A-level, particularly in English and maths but also in other areas. Those would be delivered in twilight time, which is a time where the College has capacity, 205

normal full-time courses have finished, the building is still open, still being heated, still lit, still has caretakers, adult community education courses have not filtered through; so there is a two- or three-hour window there between four o’clock and about seven o’clock when you can use that infrastructure. Part of what we are all about is making the most of the existing infrastructure that the taxpayer has paid for. 210

The Chairman: Thank you. Q13. Mr Cretney: Could I just apologise and I will let you, Chairman, move on, but just on the

shared services, if I could take you back to that for a moment, I was going to ask whether you 215

considered it to have been a successful exercise. The Minister obviously volunteered his view; would you like to elaborate a little bit on what areas you believe could be improved upon?

The Minister: Certainly. On a visit recently to Ballakermeen there were issues pointed out

with regard to the lunch provision – the food that has been there – and, while we have spent 220

£3 million recently and given them tremendous facilities, they are still having issues there with regard to the choice of food, and the queues are still quite big, and what is being offered is not what we would have thought ... and what the school actually want. So we have got an issue there with Health to sort that out.

On the maintenance of the grounds, there are issues where we would have done some of 225

that stuff before that is not happening now. Some people would say these are menial issues that need sorting out, but at some stage they

become a health and safety issue. At the end of the day, we have got to look after the students and the staff that are in those buildings.

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Mr Cretney: Thank you.

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Q14. The Chairman: Thank you very much. Just moving on, earlier in the summer you issued a press release saying that the Department

plans to bring forward a new Education Bill, possibly in the 2016-17 legislative year: 235 This will be the biggest overhaul of legislation governing education since the 2001 Education Act.

Can I ask: why is such an overhaul necessary and what that is new is going to be in legislation that is not currently in legislation? 240

Prof. Barr: Okay. Can I just start by saying obviously we had hoped that the Education Bill was

going to be progressed in this parliament and obviously, due to the amount of legislation that is going to be presented to Tynwald our legislation was, in a sense, bumped into the next parliament and I think, as a Department, we were disappointed by that. 245

You asked about what we want within this legislation and why it is important. There are a number of things. Special education needs is not covered properly in the existing legislation. We need greater clarity in that area about the type of entitlement ... the expectation that parents might have of what we can provide in that area. It is very weak – the legislation in that area.

We need to really address the issue of the fact that it is very easy for somebody to set up an 250

educational establishment here on the Island. Some of you will remember the hotel school in Port Erin and various other educational

initiatives that have been brought forward. The Department has no power to inspect those facilities to determine the quality of the education and what has happened in the past on more than one occasion is that those private providers have failed for one reason or another and then 255

Government, through the Education Department, has then had to try and pick up that education provision. That has caused a lot of disruption and distress to young people who, in good faith, have entered into those educational arrangements and then either not got the qualifications that they expected or got no qualifications at all.

So we need something in the legislation that provides us with a greater capacity as a 260

Government, not necessarily to stop private providers but to make sure that actually what they are doing meets the standards that we would expect across the Island.

Q15. The Chairman: Is this different from the position in England then, where there is a long

pattern of private provision and English education law, like ours, puts a duty on the Department 265

to provide schools, not to provide education; it is up to parents to acquire education, either by accessing state-provided schools or otherwise?

Are you saying that in the Isle of Man we want to be in a position of setting education standards which private providers would be expected to adhere to?

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Prof. Barr: I think we would want to reassure ourselves that parents do have the choice to do what they wish with their children in terms of education, that the choices they make ... that we are reassured that the education provider is living up to their side of the deal in terms of if they make claims that they are able to provide a particular qualification that that, indeed, is the case.

So, in a sense, it is almost like acting as a guarantor to the consumer, in the sense to make 275

sure that we do not have some of the things that have happened – and I do not wish to go into those in detail but there are a number of cases which the Department can point to where we have had people who have gone into private sector educational arrangements and young people have then not got the qualifications that they thought they were going to get.

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Q16. Mr Cretney: And by failing, can bring the Island into disrepute. Prof. Barr: Indeed, I think there is a reputational risk to the Island as well.

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Mr Cretney: Yes. 285

Q17. The Chairman: What else will be in the Bill? Prof. Barr: We also want to give the Department a bit more power and protection over some

of the issues in relation to vexatious complainants. We have a very small minority of vexatious 290

issues which are very time consuming, very expensive with regard to taxpayers’ money, and time for officers. I think at the moment, again, we are very weak in that area and we look to bring forward some legislation in that area.

We would also like to bring forward some provisions that would actually strengthen our ability to inspect our existing educational provision in schools and also Isle of Man College – the 295

inspection regimes at the College are fairly weak in terms of what is there. We do have those things but there is nothing in the legislation and I think that we need to tighten some of that up so that we can actually assure ourselves of the quality of our primary schools, high schools and the College.

I think there is also a need for some greater clarity in relation to out-of-catchment requests – 300

some of those issues as well, where again the legislative framework is not really particularly strong.

Lastly, we need to have some legislation that tackles the whole issue of quality of education in pre-school and, again, that is something else which is lacking at the moment in terms of we have nothing in our existing education legislation that would actually determine the quality of 305

educational provision being provided in pre-school. Q18. The Chairman: Right. Thank you. You have raised a number of points there that we would like to come onto in any event, so if

we may move on, unless ... David, you are happy to move on? 310

Just before we do, because it is connected with legislation, Minister, you did withdraw, at the July sitting, the Education Council Amendment Order and it is coming back ... well, it is not coming back in October but – (The Minister: November, Chairman.) November. Without pre-empting what you might announce at Tynwald, what is the latest position on that?

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The Minister: Yes, we are still reviewing it, Chairman. I was asked by a couple of Members if we would go away – well, I was asked a couple of questions which put some doubts in my mind but also, with Tynwald’s blessing, I was able to take that away and have a look at it.

We believe there are probably some savings to be made – financial savings – but also some improvements that could be made to the Education Council. So in discussion with Council over 320

the summer period ... I will be bringing that back to November. The Chairman: Okay, thank you very much then. Prof. Barr: You might want to know the Education Council ... some of them have been invited 325

to a meeting tonight and they are meeting with our Legal and Admin Officer, Andrew Shipley. There is no intention to get rid of the Education Council because, of course, that is enshrined in primary legislation.

Q19. The Chairman: Right. Thank you. 330

One of the issues you referred to was pre-school education and, of course, the educational standards for private and third sector providers was one of the issues explored at length by Tynwald and by this Committee in its report to Tynwald, in the context of the ending of pre-school state-provided education – albeit to half the children of the Island – and of course emphasis was given to the fact that with now private providers stepping in across the board, 335

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there would be education standards to be applied so that these establishments are worthy of the name of pre-school education, not simply childminding services.

So the question really is: what has been done over the last three years to establish and apply, in conjunction with the Department of Health and Social Care, those educational standards, which is something that you said you would be doing? 340

The Minister: We are continuing to liaise closely with the Registration and Inspection Unit of

DHSC, Chairman. We have been invited – and it is purely by invitation only at the moment – to go out with them and inspect, and that has been done.

We are working to change the legislation to make sure that is done and enshrined – that we 345

work together in the future, but at that moment it is purely by invitation from DHSC to go out with them on those inspections.

Q20. The Chairman: This is the regular inspection of premises (The Minister: Yes.) that, as a

Social Services Department, they are obliged to undertake. So are you saying those inspections 350

are now incorporating looking at the education standards; and where are those standards then to be found or written down? I appreciate they are not in legislation, but when were they drawn up and who were they agreed by?

The Minister: There was testing ... If you remember, Chairman, last year when we were here 355

we had the tests from the year before and they are done in the first term of when the pupils move up into the reception year. They are done and we will get those sometime later this term – on the standards of the education in those –

Q21. The Chairman: You have had a year or maybe two years of that to – 360

The Minister: Yes, we got the first year results last year and we will get the second year this

term and that means before Christmas. Q22. The Chairman: So as far as the first set of results, what did they demonstrate or were 365

you able to draw any conclusions, given that they were the first results under the new system? The Minister: Yes, the standards had actually risen very slightly. Whether that was by fate or

what, I do not know. Just because there had been a change that year, the standards had slightly gone up that year – last year ... But this year we will have a better result, we will have another 370

result which we can compare and see for the second year into the change. Q23. The Chairman: So against what are you measuring these results in terms of standards?

Are there educational guidance notes available to the operators of these pre-school nurseries? Is there a recommended curriculum to follow? 375

Presumably, when you were providing the education and it was teacher-led, there would be clear teaching principles applied. How is it exactly being done now in these places?

Prof. Barr: The answer is that it is done very much almost on a grace and favour basis

because we do not have any legislative powers to insist that nurseries comply with this. This was 380

one of the reasons I was disappointed that our legislation was not brought forward – because we have no legislation that requires nurseries to do this.

We have a number of nurseries that are actually excellent across the Island. There is a course being run by Isle of Man College and there is a kite mark award which actually dovetails this nicely into how educational provision should be delivered in that age range, and we have had a 385

lot of good work done in conjunction with Chrissie Callaghan – one of the officers of the Department. She is a real expert in this area and does work with the British-Irish Council in this

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area, so we have somebody who knows this area well. We have the College which is delivering training in this area at a number of different levels. All we can do is encourage nurseries to participate in that process at the moment. 390

Q24. Mr Cretney: If nurseries were to use buildings in the ownership of the Department of

Education, could you not have a say in the ... or are you saying you cannot? Prof. Barr: No, because there is nothing in the ... they are private sector providers so it is 395

entirely up to them how they manage those things. Indeed, I think there is an issue about this in terms of how the private sector responds to children with special needs, because that comes at an additional cost, and how far the private sector wants to deliver in areas which it might regard as being not economically viable ... For example, we know we have no nursery provision in the far north of the Island. 400

I think those are issues that have been thrown up by moving this into the private sector. So I think Government needs to think carefully about bringing in some additional legislation in this area, because at the moment it is very much on the basis of almost a negotiation with the private sector provider; and some of them, as I said, are very good but we do have certain issues within this regard. 405

Q25. Mr Cretney: One of the issues in the past – and it was not completely across the board,

but one of the issues – used to be that areas of potential social deprivation were amongst those that were considered appropriate. Does that still ... because that might not necessarily match up with a market-based approach? Does that still tally? 410

Prof. Barr: I would not disagree with those comments. I think if you look at this you can see

that there are areas where you would have hoped and expected that nursery provision where we do not have it – in Douglas and elsewhere.

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Mr Cretney: Thanks for responding. Q26. The Chairman: On special education needs, one of the specific recommendations in

May of last year by this Committee when it took the report to Tynwald was that: 420 The Department ... and the Department of Health and Social Care should assess the impact of the 2012 pre-school reforms on the Government’s ability to identify children with special educational needs, and report with recommendations on what action could be taken in mitigation.

So the question is: when do you expect to report with any recommendations? 425

Prof. Barr: That is something that Chrissie Callaghan is working on and we would anticipate a

report forthcoming ... I cannot give you an exact date. Again, I am happy to provide that date outside the Committee. I cannot just remember off the top of my head when exactly that would be, but Chrissie Callaghan has been doing a piece of work in that area. I know you had some 430

discussions in Government about some of this last week. Q27. The Chairman: So when the Tynwald Policy Decisions Report states that work is

currently underway with registration and inspection services with DHSC, that is what you are referring to? It talks about enhancing quality assurance provision, but does not actually say 435

when it is going to report and the clear intent of Tynwald was that you actually report that there is something in place.

We are three years on now and it was a concern that special educational needs, which were very well identified at places like the Pre-assessment Centre at Pulrose, etc. ... that this would be

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missed or lost somehow under the new system. So you will be reporting on this, is what you are 440

saying. Q28. Mr Cretney: Could I just go back to a point that we discussed a moment ago? In terms

of areas of potential social deprivation, if the private sector were not inclined to make provision in those areas is it something you have considered that the Government may get back involved 445

in providing? The Minister: The decision was made not to and at the moment Government, through

Treasury, are providing the voucher system to make that work and to allow children to go. But, as far as us setting up, that decision was made not to. 450

Whether we are getting to the stage where we find that we have a huge issue of an area and it needs something looking at ... I mean we are always looking at these things. In fact, my colleague from Education, Mr Malarkey, has already mentioned it in your own areas, Mr Cretney. That is one area – South Douglas – that needs looking at. Those things are ongoing and are looked at continuously. 455

Chrissie Callaghan does notify us of what is going on in certain areas. We are aware of certain issues in certain areas, if I can put it that way, that are always being looked at.

Q29. Mr Cretney: You will know better than I, but it is such an important time in a child’s

development that if there is an area which is not being properly accommodated then I hope you 460

do take it seriously. The Minister: It would mean a change in policy to do that but I mean – Prof. Barr: There are other potential ways you could do this, Mr Cretney. Obviously, 465

Government could incentivise, in some way, private sector providers to also go into those areas. So it is a question of what policy we look at.

What we are not saying today is that we think that the system is perfect. There are clearly issues that we are looking at, we will be reporting back on and it will then be to determine what course of action we take to address those issues. 470

Q30. The Chairman: Does every child who wants five two-and-a-half-hour sessions, which the

new system was intended to provide universally ... Is there enough money to ensure ... ? Is that happening and is there enough money in the current and next year’s budget to ensure that?

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The Minister: There is. We are led to believe there is and there certainly was this year, Mr Chairman. Again, the issue there is the provision of somewhere local to that child, but at the moment the money is there to do that, yes.

Q31. The Chairman: Okay. Thank you very much. 480

One other primary legislation issue that you referred to ... But before I come on to it, catchment areas policy, you brought up. What is the current situation? Is the policy still that a child can go to a secondary school outside of catchment, provided there is room for that child?

Prof. Barr: Indeed it is and previously we used to have one or two officers who would meet 485

with families and make the decision in terms of whether people could go out of catchment, both in primary and in high school; and sometimes there are good educational reasons to allow those moves, or indeed even good family reasons. Families move, so why would the younger brothers and sisters not then go to the same schools, and it becomes easier for working parents perhaps for children to be transferred from one school to another. 490

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We do, however, think that we need to be more robust in terms of our catchment areas. We are aware that there are a small minority of our headteachers who would prefer it if we did not have catchment areas. The Department’s policy has always been to have catchment areas. We see them as a key lever in terms of actually using our existing school infrastructure better.

So, by redrawing catchment areas, you can then potentially move groups of children from 495

one school catchment area into another, and you get periodic fluctuations in population. So you do not want some schools running at half capacity and some running at 120% and how you can actually manage that ... and we do have some capacity in some of our primary schools and rather than say, ‘Let’s close primary schools!’ is it not better to actually manage this in terms of making school populations actually fit the existing schools that have been bought and paid for. 500

That remains the policy of the Department. Q32. Mr Cretney: You indicated you were going to be a bit more robust. I was actually going

to ask you whether opportunities for you actually being a bit more flexible ... and if I could use a real life example, there is a new small estate called Pulrose Farm and the children from that 505

estate are required to attend Anagh Coar School across a very busy road in order to get to it, yet Kewaigue School is just behind them.

Is it not an area where you can be a bit more flexible in certain situations? Prof. Barr: Yes, I think I meant ‘robust’ in the sense that when we make those determinations 510

we then stick to them. That is what I mean. Not that we were just going to have a blanket, ‘We are not going to be flexible!’

I think annually we are going to have to review this and make the determinations that x school is actually falling a little bit, school y is actually already full, so could we then redraw the boundaries so some of those young people could then go to the other school. 515

Mr Cretney: Thank you. Q33. The Chairman: One of the other matters you referred to, covered by the Bill, was

vexatious complaints. Just looking at complaints – not necessarily the vexatious ones, but the 520

complaints procedure that you have at the moment, typically complaints against teachers, individual teachers or schools, you did say, Minister, in July Tynwald that the procedure would be reviewed over the summer months, so the question is: can you give us an update on that review?

525

The Minister: Yes, basically it has been done, Mr Chairman. The only thing we are waiting for now is there is also a central review of Government staff – complaints against Government staff – so we want to make sure that ours mirrors that and there is no great difference.

But basically we have reviewed that and, yes, we know it was not perfect and it will never be perfect, nothing is perfect, but it will be better than it was. We know there were places where 530

areas should have been tidied up and tightened up, and hopefully that has been done. As long as our complaints procedures conform with the Government’s –

Q34. The Chairman: Where would the procedure need to be tightened up, in your view? 535

The Minister: It was just with regard to who does the investigations. While we were happy with it, we could see why other people are not, so the procedure and who gets invited to do the investigation, that was the main issue, I think.

Q35. The Chairman: So if there is a complaint against a teacher, the present procedure is that 540

another teacher from another school would conduct the investigations, so it is a –

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The Minister: Obviously a teacher higher up the ladder. Q36. The Chairman: Higher up the ladder – but it would be a question of peer review 545

professionally. Is there a case to move out of that situation and have somebody that was not a teacher

investigate the complaint? The Minister: Yes there is, sir. 550

The Chairman: Yes. Prof. Barr: I think it is one of these things that we as a Department are looking at. My own

personal view – it is not the policy of the Department – is that we need to have a complaints 555

procedure that looks independent and, at the moment, having a senior leader in one school investigating an issue in another school ... it may well be professional and in fact I would argue that in almost all cases it is, but it does not, I think, to the general public, convey a sufficient level of transparency and challenge.

I think this is something, again, which we would look to bring forward in our new Education 560

Act. I think that there is a case, potentially, for even an independent ombudsman who actually has the skills to do proper investigations, because one of the issues that I have encountered across Government in this role is that all too often we ask people with busy day jobs to actually conduct complex investigations.

Inevitably, because they are fitting that around their day job the investigations take far too 565

long, people then think that Government is stonewalling, that we are trying to cover things up when, in point of fact, it is simply that the person is not a trained investigator and is trying to do it around their day job.

So the whole thing, for me, needs to be sharper, more independent and more focused, and hopefully would then yield better results, I think. 570

Q37. The Chairman: I think the Committee would welcome what you have just said, because

we have had evidence of dissatisfaction with the length of time it is taking to investigate – up to a year in some cases – by which time the child has gone off to another class or another school and there is no redress. 575

So the failure of Government really to do anything about an independent ombudsman and the Tynwald Commissioner for Administration Act that was passed four or five years ago needs urgent attention. Can I ask the Minister: is this, with your Education hat on, something that you would be anxious to pursue with the Council of Ministers, whose ultimate decision it is to implement this, or not? 580

The Minister: Yes, very much so, Chairman. Just speaking with my Education hat on, it is

something Prof. Barr and I have spoken about and, although he said they were his comments, it is something we both believe in. I believe it is the right way forward.

As he said, we are expecting more of less staff around Government and we expect them to 585

do the same, if not a better job, and that is just not going to be possible in the future; and we see this as probably a good way forward.

Q38. The Chairman: Yes, the vexatious nature of some complaints can be especially stressful

for everyone involved and expensive, potentially. How would you see legislation dealing with 590

vexatious complaints? Prof. Barr: I think there needs to be some kind of recognition of a very small – and I do stress

this; a very small – number of individuals who are almost serial complainants of Government

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and its services; and I am sure these people are very heartfelt in their views, but these repeated 595

complaints ... and, again, I think this is a cross-Government issue; I have heard colleagues in DOI and in Health and Social Care reference these kinds of issues as well.

It is about how we, as a Government, have a mechanism to finally say no to such individuals in the very rare occasions where you can establish that there has been a consistent pattern of criticism of Government and an attempt to get money out of Government. I think it is how we 600

just provide some kind of additional mechanism there to try and just control that. Q39. Mr Cretney: Isn’t that one of the areas within Freedom of Information that there is

going to be a mechanism in terms of voluminous or vexatious requests? It is a modern day phenomenon. Is that an area that you think will cover part of the concerns there? 605

The Minister: Freedom of Information? (Mr Cretney: Yes.) Yes, hopefully so. As Prof. Barr has

just said, there are certain people who are known throughout Government to take up an awful lot of time and money, and we have to know exactly when to say enough is enough. But, that said, you also need to make sure you do it at the right time. 610

Mr Cretney: Yes. Q40. The Chairman: Another topic that you touched on with the Education Bill, I think, was

to do with data. If you did not mention it I will anyway because, as you know, this Committee 615

reported to Tynwald about the centralised pupil database and Tynwald-approved recommendation, that Regulations under section 16 of the Education Act 2001 be brought forward without delay. What is the latest on this secondary legislation that Tynwald expected to be in place?

620

The Minister: The update on that, Chairman, is it was being worked up until the officer who was doing that retired and we have not picked that up since. That is something the Department basically needs to pick up again. But that piece of work has not yet been finished.

Q41. The Chairman: Because it is 18 months ago since Tynwald said, if you are going to 625

collect data for very good management reasons, you need proper legislative framework for that to happen and the Attorney General eventually agreed that point, but yet it is still not in place.

The Minister: It is not and, as I said, it is due ... John Gill is the officer who was drawing that

up and he has now since retired. John was also doing our Education Bill and, due to Government 630

deciding on the priorities before the Election next year, the Education Bill has gone by the by until after the next Election. This other piece of work was not finished either.

Q42. The Chairman: Where the Tynwald Policy Decisions Report 2015 says in relation to this

that ‘the recommendation will be considered’ – never mind implemented, ‘considered’ – ‘within 635

the forthcoming Education Bill,’ which is going to be 2016-17, that is not quite accurate, is it? It is not the same as what you have just told us this afternoon? You said that it will be

implemented, it will be secondary legislation. The primary legislation is already there, which enables the secondary legislation. We do not need to wait for a new Education Bill to do this, do we? 640

The Minister: No, if I said that I am sorry but what I was saying was – Q43. The Chairman: No, you did not say it but this report does say it will be considered

within the new Education Bill, but we do not need to wait for that because you can do it now, 645

when resources allow.

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Prof. Barr: Yes, and indeed now we have got Andrew Shipley in as a replacement to John Gill. We would anticipate him bringing this forward.

What I can say is that we are not proposing to add any additional database fields to any of this, so it is just the ones we already collect, and that, obviously, under the Education Act 2001 650

we have the vires to collect the data in the database and we accept that, but we need to bring forward that second legislation and all I can do is apologise to the Committee that that has not been done. It is something we should have had done by now but, as I say, Mr Gill was under a lot of work pressure and you will appreciate in the lead up to retirement he was also dealing with two extremely vexatious complainant issues on top of what we had in good faith been pursuing 655

in terms of an Education Bill. So it is just something that did not get picked up. Now that we have a replacement in place, I fully anticipate that the next time before we

appear before this Committee we will have made some legitimate progress. Q44. The Chairman: Thank you for that assurance. I think that answers the misunderstanding 660

that is evident in the report from the Council of Ministers about it. Thank you very much. Just moving on then, a press release in the summer referred to the school self-evaluation and

review process, which is largely taken over from external Ofsted inspections, or totally taken over. Are you satisfied that it is a sufficiently robust process, to do this as an internal review, excepting that there is some external validation ... ? Is it still a robust enough process that will 665

actually drive up standards? Prof. Barr: I would argue and say that we are satisfied; we do believe that it is rigourous and

effective. We have had, certainly over the last couple of years, senior educational figures from the UK who have been here, we have had the President of the National Union of Teachers, who 670

has been here and went on radio and said what an excellent and innovative primary school system we have here; so much so that they then brought a group of headteachers across to the Island to look at what we were doing here in terms of how innovative and what a good system it was in encouraging young people.

So I think we are satisfied that the self-evaluation process ... that headteachers and deputies 675

understand what ‘good’ looks like and that we have link advisers who are attached to schools for three years and then are rotated around to other schools so they do not get too cosy.

So typically a link adviser in primary will have about eight primary schools that they are responsible for. We would then move them to a new portfolio of schools. We have two secondary advisers and, again, their job is to go in and robustly challenge those schools. 680

Obviously, in terms of leadership and management, we brought in the former head of the Scottish education leaders – a longstanding headteacher of 20 years’ experience, Ken Cunningham – to do the performance management for our secondary headteachers; and we have currently got a retired principal – again, from Scotland – who ran a very successful college in Cumbernauld, looking at the committee structures and QA structures at Isle of Man College. 685

He is going to produce a report for us in December. So I think it is a blend of local experience and knowledge which sits with the Department, but

also we do have these external points that we bring in from time to time to make sure that we are, indeed, doing what we think we are doing. I think that is where we are with that.

Again, I would draw attention to the results. GCSE results this year were up by another 2%. 690

That is the fourth year of improvement in terms of GCSE results, against a backdrop of extensive curriculum reform and financial pressures. So actually we just, for the Committee, put on record that the Department is really proud of the work that teachers have done in our high schools over the last couple of years, because that is a lot of pressure on individuals – curriculum reform, financial pressures, shared services, which disrupt things in the short term – and yet we have still 695

managed to achieve an improvement in terms of GCSE results.

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Q45. The Chairman: Where have the improvements been in particular? Are there particular schools – ?

700

Prof. Barr: Well, we were delighted that there was significant improvement in English and that that was reflected by the International GCSE, where English was one of the first areas to move in that direction, and the results have gone up in the IGCSE in English. So we are really pleased with that.

I think also across the Island we have had two new headteachers put in place at Castle 705

Rushen and at Ramsey Grammar, and they are doing an excellent job as well, in terms of moving things forward. Obviously, we have some experienced heads in Sue Moore and Adrienne Burnett and Andy Fox, and collectively the results are looking good. There is still room for improvement and we want to see that improvement continue, but I think, by and large, roughly speaking, an 8% improvement over four years is definitely the direction of travel and we want to see that 710

continue for a few more years yet. Q46. The Chairman: Yes, whenever there has been comparisons in the past with UK or

English averages, the answer has always been, ‘Well, such comparisons are like comparing apples and pears; they do not equate because one system includes resits for the same exam and 715

the other does not and, therefore, it can be a bit misleading.’ Against what are you measuring then the improvements? Is it on International GCSE

benchmark standards or is it historic standards in the Isle of Man, or what? Prof. Barr: We look at it in terms of the historic standards, in terms of year on year; where 720

were schools the previous year and where are they this year in terms of the results; have the results gone up or have they gone down?

In the cases where the results have gone down the schools are then challenged and occasionally you can get a statistical blip; where you get particularly a further year of declining standards that is something the Department would take extremely seriously. In fact, it is at the 725

core of what the Department should be about in terms of guaranteeing and driving up standards.

So we take all of that extremely seriously. That information is shared with political Members and with the Minister at departmental meetings; it is shared openly with the headteachers in terms of, ‘These are the results. This is where we are.’ But we are also aware of the pass rates 730

and standards across England and Wales. We routinely look at how that looks in terms of the north-west versus the Isle of Man.

In terms of our pass rates and success rates, the analogy of apples and pears, I think, is a fair one to make. Certainly until a year ago, we know that, for example, in England they included those who had done resits in English and maths in their pass rates, whereas here in the Isle of 735

Man we were only looking at ... if you passed first time you were included in the statistics. So you were not comparing like for like, because in England the statistics were inflated by the

fact that people had had a second go at passing their English and maths, which we were not benchmarking here in the Island. So you get these anomalies from time to time in the system.

So while it is important to have a general awareness of those educational standards in 740

England and, indeed, in Scotland and Ireland and elsewhere, I think it is about still remembering that in the Island we do have a very different educational landscape; we do not have Ofsted. One other thing that is good about not having Ofsted is our system is certainly cheaper to run than if we brought in a full Ofsted system into the Isle of Man.

745

Q47. The Chairman: When Ofsted ... I remember when it first came in and it was a deliberate act of the Minister of the day to introduce Ofsted because there was previously no sufficiently robust evaluation taking place and Ofsted did reveal some very revealing and not altogether welcome truths about some schools – certain schools – at the time.

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It was across a very stressful exercise in terms of teachers preparing for Ofsted and it was a 750

very unhappy experience for individual members of staff, albeit that in the Isle of Man Ofsted inspectors liked coming here because they were free to engage and talk to staff, and the Department used that as an opportunity for improving schools, rather than just a step back and cold clinical assessments. But, nonetheless, it was a stressful time.

So I suppose what I am saying is the current evaluation system is presumably much less 755

stressful; you are saying it is still sufficiently trustworthy and the results speak for themselves – would that summarise the situation?

Prof. Barr: Yes it would and the fact that we do have certain elements of external validation

... I have referenced Ken Cunningham’s role with our headteacher staff appraisal and evaluation; 760

I have referenced the fact that we have got this man, Brian Lister, looking at the College. We have an external company called WCL lead inspection, where they actually are used by us to iron out any disagreement in reports that are produced, so they are an independent arbiter that looks at those as well.

So we do have that externality and I think the Department is very much aware that in any 765

island community you can have a danger of always looking inward and thinking that you are doing a good job, but not actually benchmarking it against what is going on beyond your own shores.

That is something I think that as a Department we are very much mindful of, but we would not want to have that heavy Ofsted process brought into the Island; if for no other reason than 770

because, again, things like testing of primary schoolchildren ... we just do not do. There are fundamental differences between some elements of our system and how things

operate in England; and we know that there is a pressure on creating academies in England which, rather perversely, goes against the whole notion of shared services. It is the exact opposite, in some ways, of giving schools complete autonomy from Government. So you have to 775

be careful about what lessons you pick up from different educational systems. Of course we are in a very fortunate position where we can look across not just to England

but at what is actually happening that is of value and good practice in Northern Ireland or in Ireland or Wales or Scotland or elsewhere, and I think that allows us, I would like to think, to have the opportunity to pick a mix of things that actually works best for us. 780

Q48. The Chairman: I think the Committee would certainly share the approval and

congratulations to staff and pupils for the results that have been achieved this year. The International GCSE, of course, was overwhelmingly recommended and agreed by parents

and the profession and everyone else, and by Tynwald as the new model. Given that it has 785

diversified from the new English model in terms of continuing to recognise the value of coursework – and the political argument about that was that more robust testing in exam situations ... written exam, formal situations, would set the higher standard in benchmarks – is your confidence, Minister, of the decision of going to that International GCSE being borne out in practice or is it too early to say? 790

The Minister: I would say, Chairman, it is probably too early to say. Even though we were at a

slight rise in the increase in exam results again this year, I would say I would not rely on that, it is just the first year, it is far too early to say.

The feedback that we are getting though is very positive and hopefully it will continue next 795

year again; hopefully we will see another rise and we will have a better idea then. Q49. The Chairman: Okay. Just moving on to higher education, the new student loan system, the ending of universal

grants was quite politically controversial at the time when it was introduced. One of the issues at 800

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the time was concern about the default rate on loans. How is that working out? Is it as predicted or is it too early to say?

Q50. Mr Cretney: Or again the budget – do you think there are going to be any modifications

to the scheme? 805

The Minister: Again, Chairman, it is probably too early to say. What we do know is we have

had the first few that have come back and said, ‘Thank you very much indeed. Here is your money back.’ We have already had a couple of cheques that have done that and one or two have actually cleared their whole loans account. 810

What is the loss or the write down on it? I think, across, the figure was something like 45% and 48% on their figures on pay back; we believe it will be a lot less here. Again, as I said, it is early, but we believe it would be somewhere between 20% and 25% – but again we will not know and hopefully it will not even be that.

815

Prof. Barr: It will be July 2016 before we have the first full determination, because that is when the first cohort of students will have run through their full degree programme.

Q51. The Chairman: Fair enough. Yes, thank you. Isle of Man College, we understand, is to become a university college in its own right, 820

accredited degree-awarding powers, associated with Chester University. Would you like just to say something about the position of Isle of Man College? It will be getting a new principal there soon, presumably the new higher education status of this is something that, Prof. Barr, you have been pushing for since your appointment, along with the Minister?

825

Prof. Barr: It is something I have been pushing for for more than nine years! (The Speaker: Yes.) But I think, just to correct that, we will not have our own degree-awarding powers.

The Chairman: Oh, you won’t? Right. 830

Prof. Barr: Not in the first instance, but it is about growing higher education on the Island and we think that this makes good financial sense. We can give Isle of Man College £3,000 for each HE student it has. That means Government saves £6,000 straightaway because we currently pay £9,000 for every student who goes to a UK institution. It also increases the on-Island spend on Island, because obviously young people are here and will then be spending money here and 835

contributing to the economy here. We think this is potentially beneficial to working parents who have been hit with charges,

increased pension contributions, very poor – if any – pay rises, and it costs a lot of money in maintenance to pay for rent and food for your child to go to Leeds or Edinburgh or Manchester or wherever they end up going, and potentially in a range of courses – not all – to offer, at the 840

least, the opportunity for people to do their first year here on Island and then to go on and do their subsequent years off Island.

About a third of our high school teachers have master’s degrees, so from an academic quality point of view, they would be well placed and there would be no issue with them delivering first year provision in non-lab-based higher education. 845

So we think that there is the potential to grow higher education that would save middle-income families money, would actually increase student choice because we are not saying that you cannot go away for your full degree, but you may consider that another year on Island would give you a bit more emotional maturity, allow you to play for another year with Laxey Football Club or be with your boyfriend or girlfriend, and at the same time you are saving your 850

parents a year’s maintenance costs in the UK and we think that that would be something which would actually be determining whether that person could go to university or not.

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So this is something we are very keen on developing. We have spoken with the University of Chester. I am meeting with the Vice-Chancellor and Pro-Vice-Chancellor on Monday to start progressing these discussions with a series of milestones; and the Minister and I are over in early 855

November for the graduation events and we have got some follow-up meetings with the University then.

We hope to have the University’s input in terms of determining the job description for the new principal and we are also working very closely with the private sector and the investors at the Nunnery, because we also see them as having a role within the university college. What we 860

want ideally is a university college that involves Isle of Man College, the ICT at the Nunnery, the Department and the University.

All of that then becomes linked up together so we think that is a fairly exciting initiative for us as a Department and it is one of the things that we have put forward as a legitimate cost-saving proposal for Government. It is actually a policy that could save Government money and actually 865

enhance choice. Q52. The Chairman: The business degrees that were being done – the John Moore’s degrees

– at the Business School, are they still being taught at Isle of Man College or have they finished now? 870

Prof. Barr: What happened was that when the International Business School was merged

with Isle of Man College, the students who were in their final year with Liverpool John Moores were allowed to complete with Liverpool John Moores, the second year students were given a choice and the first year students transferred across to Chester. So that has rolled through, so 875

now of course all of the students are badged with Chester because that merger took place more than two years ago.

So LJMU has no presence within that structure now. The College, as you have rightly indicated, is an associate college of the University of Chester. That reflects agreements that have gone back over a 15-year period and about four years ago the University invited the College to 880

become an associate college. The benefits for us are that that allows us to fast track degree validations through the

University, because they are reassured about the College’s quality assurance and the results. I think, again, we are talking about relatively small class sizes and typically results which often score higher than corresponding courses delivered in Chester. More people are getting 2:1s and 885

1sts. So I think that is where we are with this and then, of course, if you are working with one

university you are only working with one set of quality assurance; and each university does ask a fee for using its badge and its arrangements, so the more we can simplify this, the more money we can save. 890

The Chairman: The – David. Q53. Mr Cretney: Sorry I was just going to ask, in particular, about ... One of the things we 895

hear much about, in terms of the needs of the economy, is IT skills and I was going to ask you: would you like to further elaborate a little bit about how progress is going on in terms of development of the Nunnery by the private sector and working in conjunction with the Department to get the skills that the Island clearly needs?

900

The Minister: We have worked very closely over this year with Mr Vermeulen who has now purchased the Nunnery office and it is his intention to, hopefully, open the ICT down there at the Nunnery next September.

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As Prof. Barr said, there are another few meetings coming up before the end of this year. Chester are on board with this and working with us and working with them as well; and 905

hopefully between Mr Vermeulen and ourselves and the staff at the College and Chester University, we can progress this; and, as Ronald said, next September hopefully we will have something down there under that one badge.

Q54. The Chairman: The Isle of Man Government has inherited a number of academic links 910

with other institutions – different Departments of Government, particularly in the industry side. I just wonder: are they going to, over time, be absorbed under this single relationship with the benefits of costing and accreditation, or will they continue?

Prof. Barr: I think that depends, Chairman, on their circumstances. Nobody would want to 915

prevent a particular initiative based around economic development. So, for example, if there was a particular university with a particular skill set that was going to develop the economy in a particular way, I think that sits outside this.

I think the bigger question is how education and training at what we would call level 4 and above, which is first year university equivalent or above, is delivered across the Island. I think it 920

has got to be something inevitably that is done in stages. The first stage is for us to get an appropriately qualified principal, to get the re-brand launch

and to start bringing forward new validations and new programmes and to recruit students to those programmes and to make sure the academic quality is such that students go away as our best advert, and that is how we will grow this and move it forward on that basis. Hopefully, if we 925

get a critical mass going forward then it would become easier and more apparent to that provision, which Education does not control, that it would want also to align itself in that area. By and large, that is now controlled by the Office of Human Resources. They took over Keyll Darree under shared services and the educational provision there.

So we have a level 4 and above provision that sits both in the Office of Human Resources and 930

at Keyll Darree which is managed by the Office of Human Resources – some of that is professional courses and training, but it is still at university level and it is an aspiration of this Department, I think, for that finally all to be brought together and you could really have a critical mass of students that was very significant. As you will probably know, they dropped the tariff in England to become a university in your own right from 4,000 students to 1,000. With a 935

population base and size of this, if we were to consolidate the whole lot we would be very close to that 1,000 figure.

Q55. The Chairman: Okay. Just going back for a moment to those who do go off Island, universities have been applying 940

overseas rates which I think have taken over from the Island’s rate that we used to enjoy, along with the Channel Islands. When the new system was being debated there was some discussion about the level of tuition fees being charged by certain universities – Cambridge, Warwick, Imperial College – which were going to be full overseas rates and completely in the stratosphere as far as the Department was concerned. 945

Were you able to successfully negotiate downwards better rates, if not at domestic level, better than full-blown overseas?

The Minister: We believe we have a very good deal with most of the universities and I think

there are only two universities now that charge us international rates. 950

Q56. The Chairman: Which are they? The Minister: Cambridge and Imperial, and I believe that every now and again when you get

somebody who asks us to challenge that – ‘Go out and ask them again.’ – we need to be very 955

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careful because we believe that at the end of the day if Cambridge say, ‘No we are within our rights’, and if we bring too much notice to it, other universities may well turn around and say, ‘Actually, we are going to bump the prices up for you as well.’ One or two of our colleagues in other islands are tempted to take them on. We would not do that.

As far as the courses are concerned, £9,000, as we said earlier, is pretty much the standard 960

rate for most courses across and of course you know that £2,500 is what students end up paying per year and we pick up the rest. There are certain courses that are a bit more than that.

Q57. The Chairman: Right. Okay. Thank you. Have you anything else on higher – ? 965

As far as vocational qualifications are concerned, where Isle of Man College has developed quite a wide range of programmes across the disciplines, is there any new development you want to report to us that you think would be noteworthy?

Prof. Barr: I think we are paying very close attention to this because we know that the 970

International GCSEs will not suit all our young people. So what we need is a vocational offer that sits very nicely alongside this.

One of the things that we are trialling at the moment are some of the Scottish Vocational Awards, which have very quietly gained a very good international reputation. Scotland has not trumpeted this; it first came to our attention when the Head of the Association of Colleges in 975

England, in a conversation with myself, said how wonderful these Scottish Vocational Awards were; and since clearly, as the head of the English colleges, he had no vested interest in saying that, I did ask the College to follow this up and we are currently trialling some of the Scottish Vocational Awards.

We think that they have, potentially, some merit in terms of being a very nice fit alongside 980

International GCSEs, to give us a really well rounded platform of educational opportunities for our young people, and really building on the new William Kennish Engineering Centre, what is happening at Hills Meadow with the aerospace engineering and of course the new Baillie Scott building, which we are absolutely delighted with in terms of the construction crafts ... having them all on one site and the skillset that we want them to develop in terms of heat pumps and 985

solar and green tech and all of those things. So some fantastic opportunities there, I think, for our young people and we are pushing now

the College to really capitalise on those and work more closely with the schools. The Minister: Just for clarification, the Baillie Scott wing is where the trading area was ... 990

The Chairman: Oh, yes, right. Q58. Mr Cretney: Sorry, I was going to say I agree completely with what you said. The one

part you did not mention there was perhaps – if we are talking about engineering or if we are 995

talking about construction – also working with employers. The relationship there – is that a successful one, because in particular the work of Hills Meadow and the one you have just referred to are really, in my opinion, good developments, but you are having ongoing ... ?

The Minister: We have a great relationship within the engineering industry and they regularly 1000

... the bosses from the big companies and the others come down to see us or come down to look at the Hills Meadow site and they have ongoing talks with us with regard to the way forward. They are delighted with the students that are coming out of there – on the courses that were set up especially for that – and most of the students that are coming out of there are going straight into jobs. 1005

Mr Cretney: Good for you.

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Q59. The Chairman: Thank you. That is very interesting – the developments you have told us about.

School buildings are blessed with good staff and attentive pupils, but you have to house 1010

them. Castle Rushen has been the subject of public comment in the recent past. Is there anything you wish to tell us, Minister?

The Minister: Not really that has not already been said before now, Chairman, but I am

happy just to confirm we are totally aware of Castle Rushen. It has had work done on it again 1015

this summer – a substantial amount of work. We are where we are, as they say, with regard to the capital projects scheme and that again is something else that, if we turn around and say we are going to build a new school down there and if I put a ball park figure on it of £20 million even, we now have loan repayments and interest on that to pay and that will have an effect on the Department itself, because we know that has to come from within our budget. But we are 1020

aware of that and we are keeping an eye on that. Q60. Mr Cretney: This year’s work, was that something to do with the science labs and stuff,

was it? 1025

Prof. Barr: Yes. Q61. Mr Cretney: You have obviously got a priority of what next challenge you are going to

try to improve at Castle Rushen? 1030

The Minister: Yes, there is an ongoing list which our Estates Director, Richard Collister ... Apparently he is regularly down there – well, at all our schools and all our properties, discussing and looking at them. We have an ongoing property maintenance list and that is on there.

Prof. Barr: We have done a full review of all of our portfolio of estates and the number of 1035

schools we have. Occasionally we hear about ... ‘You have far too many primary schools. Why don’t you close one or two?’ So we have done the financial modelling on that and that is something we are very keen to demonstrate – that you do not make the savings that you think you are going to make by closing a school, because the children simply have to be transplanted and taught somewhere else and you still have to have the teachers in front of them; and you 1040

end up with bigger management structures in the other schools because you then have to have a bigger management team – that is how it works.

So although you have some infrastructure savings, it is not as significant as people might think and the disruption to local communities, quite frankly, in the view of the Department, is not worth the kind of savings that you are talking about in that area. 1045

Castle Rushen – obviously, we have land gifted for development. In an ideal world the Department would love to put a brand new school on that site. Of the five high schools, it is the one that has had the least investment and we can demonstrate that. A lot of the work has been incremental over the last 15 years and, ideally, we would like to put a new school on that land that has been given to the Department, but the money is the issue. 1050

The Chairman: So the policy of maintaining a network of a very well-regarded rural primary

schools – and rural in particular – continues. I think that was quite reassuring to a lot of people. Urban schools as well, of course.

1055

Mr Cretney: Some of us have been around long enough to remember the last time, that the closure of a primary school was a big issue.

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Q62. The Chairman: Yes, and of course, economically, it may be seen… I accept absolutely your qualification about the actual savings, but it may be perceived as a very obvious thing to do 1060

to consolidate the size. It has been done in England over the years, but you lose a quality and a head start in education that these small schools are uniquely equipped to provide.

Prof. Barr: It is difficult to see how any administration could sell that under protecting the

vulnerable. (The Chairman: Yes.) I would like to see somebody argue for that on that basis. We 1065

have communities like Jurby that are, by Island standards, regarded as fairly isolated and so we close Jurby Primary School – that is the sort of thing you are talking about.

Since we still have a policy of growing the Island’s population, more than likely we would end up closing a primary school and then Dandara would build a housing scheme in what was the former catchment area of that primary school, and since we do not have a clarity of where this 1070

population base – if it does come, where it is going to be, I think it would be very shortsighted to then close primary schools until we have some strategic direction about movements of population, where people are likely to exist; and, in the view of the Department, it is much better to manage those things incrementally through the use of catchment areas.

1075

Q63. The Chairman: Yes. One of the other features of the Island's education system that has always caused pride is

things like the music service, the peripatetic service, existence of school orchestras and things that have very largely disappeared.

Primary school French was one of the things that the Department ended, which made the Isle 1080

of Man distinct. The other non-core services, shall we say, like music provision … How does that sit in the Department’s thinking?

The Minister: It is still very important, Chairman. It is still happening. We still, as you said,

have the peripatetic team and they are still very busy. So that is still being offered amongst the 1085

schools. If I just step back to French, there is French at lunchtimes. We have a ‘privateer’ who goes in

and offers French in some of the schools now. Those services are very important to us and we will make sure – 1090

Q64. The Chairman: They are safe? The Minister: Hopefully so, yes. Certainly, at the moment – touch wood. Q65. Mr Cretney: So the teacher of French, is that on the basis that the parents pay for that 1095

additional subject? The Minister: Correct. There is a small charge made and the teacher goes in at lunchtime and

uses one of the classrooms. 1100

Q66. Mr Cretney: Right and how many schools is that in? The Minister: I think it is three now. Certainly two and I think it might be three. Mr Cretney: Thank you. 1105

Prof. Barr: Just going back to the music service, we commissioned Andrew Cole who had

retired as the headteacher at Castle Rushen, who of course is a musician himself and is part of the musical community of the Island, just to do a little piece of work for us on the merits and

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value of music within an education curriculum, and to look at possible ways that one could 1110

perhaps work together. I am not sure that that will come to anything, but certainly I think we are not against being

innovative and some collaboration with, say, King Bill’s in relation to music, where we had a shared service where some of the costs were being met in that capacity. If we were to come under severe pressure to cut music it is about how you then work with others to protect the 1115

service. I think within the Department that is one of the mantras I have tried to consistently get out

as Chief Executive and, as the Committee will be aware, we also have a responsibility for the NSC and funding of regional swimming pools; and there is a piece of work on what we might do with the regional pool in the south of the Island, in terms of potential collaboration with King 1120

William's College. We are looking, obviously, to develop sports facilities, including a swimming pool.

So sometimes nothing comes of those initiatives, but it is at least worth asking the question and demonstrating then to Tynwald that you have looked at alternative options, even if they then turned out to be things that you do not do. 1125

Q67. The Chairman: The recent Government restructuring, which saw responsibility for arts

and sports come within your Department – how has that impinged on the operation of these particular aspects – have they been improved or has it made no difference, or is it a detraction from your core education activity? 1130

The Minister: No, not at all, Chairman. I think it has worked very well. Certainly the sports, working with Manx Sport and Recreation and the team down at the NSC,

has worked very well and they obviously go out and work amongst the schools as well, so that has been a huge bonus to us – and to them, I think. Certainly, working together, we have helped 1135

to safeguard, probably, jobs down there by expanding what can be offered around the schools and outside of school hours.

The Arts Council as well has fitted in very well with the Department and the Member responsible, Mr Corkish, has been there and was in the Department prior to that; and it has worked very well and we are happy to have them in the Department. 1140

Q68. The Chairman: The Department, some years ago, was renamed ‘Department of

Education and Children’. I have never quite understood why, but the emphasis of that is that the Minister… you become the lead Minister and spokesman within Government on children's issues… which, as we know, all children get education but some children require other services – 1145

have special needs, are in receipt of Social Service intervention and so on. How does that aspect of your role … ? Presumably you sit on the Council of Ministers

Committee that deals with the Safeguarding Children's Board, and all this. Does that still make sense – to have renamed the Department specifically with ‘Children’ in the title – (The Minister: No, Chairman.) given these additional … ? 1150

The Minister: I do not believe it does and I have raised this several times. (The Chairman:

Have you?) Yes and I think if somebody wants the word ‘Children’ … I think it was Minister Craine who asked for it to be brought in and it was. But I think if it was going to sit anywhere it would probably sit better within DHSC and their remit. 1155

Obviously, we have children within the Department of schools, but we now have sport and art which should also be in there, and I have mentioned to the Chief Minister during Council meetings that we ought to look at the name again. While I am not fussy about names and all sorts of things, if we are going to recognise what a Department does, you are right, ‘Children’ does not really fit in there and there is no legal – 1160

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Q69. The Chairman: Especially if we are going to be a single legal entity, then children are the concern of everybody –

The Minister: They are indeed, Chairman. They are indeed, Chairman. 1165

The Chairman: – the Government, not one Department. Prof. Barr: It has led to confusion and certainly when the Minister has been outside the

Island, having to take time to explain to other Ministers in other jurisdictions, they get confused 1170

about what the actual remit of the Department is; and, of course, there is no reference to sports or the arts in the portfolio and this reference to children makes it look as if we have some social care functions (The Chairman: Yes.) which, in fact, we do not actually have.

So I think it is confusing, isn’t it really? (The Minister: It is.) Yes. 1175

The Chairman: That is an interesting point. Thank you both very much indeed. Have you any final questions? Mr Cretney: I am fine, thank you very much, Chairman. 1180

The Chairman: No. Jonathan? I have no final questions. It just remains to thank you, Minister and Prof. Barr, very much for your time in giving evidence. We have been most grateful to you. Thank you very much.

The Minister: Thank you, Chairman, Mr Cretney, Jonathan. 1185

Prof. Barr: Thank you. The Chairman: The Committee will now sit in private. Thank you very much.

The Committee sat in private at 4.02 p.m.

140140

12th November 2015 Evidence of

Hon. J P Watterson MHK, Minister,

and Mr M Kelly, Chief Executive

Officer, Department of Home Affairs

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O F






D A A L T Y N


DEPARTMENT OF HOME AFFAIRS

HANSARD

Douglas, Thursday, 12th November 2015

PP2015/0153 SAPRC-HA, No. 1/15-16



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STANDING COMMITTEE, THURSDAY, 12th NOVEMBER 2015

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Members Present:

Chairman: Mr D C Cretney MLC Hon. S C Rodan SHK Mr G G Boot MHK

Clerk:

Mr J D C King


EVIDENCE OF Hon. J P Watterson MHK, Minister, and Mr M Kelly, Chief Executive Officer, Department of Home Affairs ........................................................................................................... 3


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Department of Home Affairs



[MR CRETNEY in the Chair]

Procedural

The Chairman (Mr Cretney): Welcome to this public meeting of the Social Affairs Policy Review Committee which is, as you know, a Standing Committee of Tynwald.

I am David Cretney MLC and I chair this Committee, and with me are the Hon. Steve Rodan, Speaker of the House of Keys and Mr Geoffrey Boot, Member of the House of Keys.

If everybody could ensure that your mobile phone is off or on silent so that we do not have 5

any interruptions; and for the purposes of Hansard I will be ensuring that we do not have two people speaking at once.

The Social Affairs Policy Review Committee is one of three Standing Committees of Tynwald Court, established in October 2011 with a wide scrutiny remit. We have three Departments to cover – Education and Children, Health and Social Care and Home Affairs. 10

Today we welcome back the Minister and Chief Executive from the Department of Home Affairs; they were last here in November 2014.

You are very welcome and I am sure you know the routine, we will go through a number of questions, the Members will jump in as and when they wish, and if there is anything you are not in a position to answer I am sure you will follow it up. 15

Thank you.

EVIDENCE OF Hon. J P Watterson MHK, Minister, and

Mr M Kelly, Chief Executive Officer, Department of Home Affairs

Q1. The Chairman: We are going to start with the matter of cost reduction which has been

topical for some time now. We would like to ask: how much has the Department reduced its costs? 20

The Minister for Home Affairs (Mr Watterson): The Department has reduced its costs massively by over a quarter since its peak spend, which has come down from a little over £38 million to just over £28 million now. That is a massive reduction in our spending. Likewise, the reductions in headcount have been significant from a peak of 591 staff to our present level of about 511. 25

So I would like to think that the Department of Home Affairs has more than done its share in terms of bearing the burden of cost-sharing for Government.

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Q2. The Chairman: Thank you. In terms of your headcount, are you content that the headcount constitutes what the public

would wish to see in terms of its services? 30

The Minister: I think, being realistic, across the public services people want as much as they

can for as little as they can. I think it is up to us in the middle, as politicians, to strike the balance and make those

judgement calls. I would certainly say that the Department of Home Affairs is a lean 35

organisation. It does not have fat and it does not have massive amounts of capacity to take on additional work; however, I do think it is run well and it is run efficiently.

I think we have got a good team there and it can deliver what I think the public expects as a good service with the money that is provided.

40

Q3. The Chairman: So you think the impact on service delivery has been one of a slimmed-down organisation but still delivering what you require it to deliver?

The Minister: Yes, absolutely. If you look across all the services that the Department provides, I think the evidence is still 45

there to say that we are providing a good quality service across the whole range of Prison and Probation, Fire, Police. The hallmarks are there of still providing good services and we have had to do that in challenging circumstances – but that is a testament to the people who are delivering them.

50

Q4. The Chairman: We have before us a document by the Internal Audit Division entitled Cost Improvement Programmes Assessment No 1, dated June 2014.

Can you tell us, have the recommendations in this Report been implemented? The Minister: Sorry, I am not familiar with that one. Whilst I will have been circulated on it in 55

June 2014 you will forgive me that it must have slipped a little bit from my memory. Mr Kelly: If I may, Chairman, I am familiar with the exercise that you refer to. This was a

study of, effectively, value for money around various different Government Departments. The Department of Home Affairs came out with the best scores of all the Government Departments, 60

which was gratifying. One of the issues which was raised was the issue of a target operating model – I think I am

correct in saying. The timing of this Report was slightly unfortunate because within a few months the Police came forward with their target operating model – which I think we will probably go on to talk about later today – which was about reducing in areas such as 65

neighbourhood policing and redistributing their resources. So I would suggest that the main issue we have been asked to address in that Report, given

that we got quite a favourable review, we have addressed; but I am more than happy to feed back to the Committee afterwards if there are any issues we have missed or if there is anything else you would like to raise. 70

The Chairman: Okay. Were there are any points …? Q5. The Speaker: If I may, Chair? 75

The Report was produced in June 2014 following fieldwork done across all Government Departments, of course, and the overall conclusion in respect of your Department – if I can just get it here:

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Overall, we have assessed the Department of Home Affairs’ cost improvement progress as: tactical with 80 promising prospects for improvement.

That was June last year. A general comment that was made by the audit people overall about Government

Departments was that:

there is very little evidence of a consistent structured approach to cost improvement … 85

I am reading from page 6 of the Report and they are saying:

... the major driver, target and monitoring device is the budget. We have very little information on whether the budget reductions achieved to date are comprehensively covering all parts of Government ...

Then this was the bit:

... whether these are savings or cuts and whether the reductions are sustainable in the long run. 90

Your Department, we observe, has been very good at achieving significant reductions for

budgetary reasons – you have consolidated services and where they are physically located. My question is, given the comment about whether reductions are sustainable in the long run,

is what you have done up to now part of a systematic programme within delivering as part of the cost improvement programme, or is it more opportunistic to make your budget balance? 95

If it is, can it be sustained in the longer run? The Minister: Well certainly early in the budget rounds, early on in this administration, the

three-year targets were set, so we kind of knew where our endgame was as far as budgets were concerned. So we knew what we had to achieve over the three years to be able to redesign 100

services and manpower – and expectations as well – around the budgets, looking forward for those three years.

We have been able to achieve that. We have had a steady state budget this year and, of course, next year’s budget will be announced in February.

In terms of sustainability I think that our target operating models now, as we have them, are 105

sustainable. Obviously the levels of budget are not, but going forward we think we have a baseline from which we can build, in terms of making sure that we have the model and the systems and the structures and the people in place for that. I am certainly happy that we can deliver that.

Obviously there will be wage increases, there will be inflation and there will be other things 110

that will apply into that ... which will mean that to apply them with the same amount of cash, we would not be able to achieve that going forward.

But I think on the whole we have a workable model. Q6. The Speaker: Is it possible that you might, having ‘cut the fat off the bone’ as it is put, get 115

to a point where your ability to deliver services becomes very marginal? The Minister: Yes. Q7. The Speaker: I know heads of service – the Chief Constable, the Fire Service and others –120

– are very conscious that you might be at the tipping point of not being able to deliver services. Are you at that point yet? The Minister: I have said that I do believe that where we are on a number of fronts

represents an irreducible minimum in terms of the model that we have. I would not want to do 125

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with any fewer police officers or any fewer fire officers than we have at the moment. I think the Chief Executive’s office is as lean as it could be.

I have described the Department’s finances as an irreducible minimum at the moment in order to provide the effective services that people have come to rely on.

130

Mr Kelly: But I take your point, Mr Speaker, we cannot just keep top-slicing because you get to a point when it becomes unsustainable, as you say.

What we have tried to do in our services is plan strategically. The Police, as I say, have put forward their target operating model and they are trying to implement that now. The Chief Constable has said that we have got to the point of cutting into muscle rather than cutting into 135

fat, so that is finely balanced. In terms of the Fire Service, they have been encouraged to produce a strategic plan which

will be coming to Tynwald before too long – and that has also been peer-reviewed by the Scottish Fire Service and the HMI in Scotland, and they think it is a realistic attempt to plan services forward. 140

You also may be aware that we have a new Prison Governor and he has, at my request, embarked on a resource review of what is available to him in the Prison and Probation Service to make sure that he has strategic plans going forward.

So we are trying to do as much as we can. 145

Q8. The Chairman: You referred in your conversation to the move from Homefield to the Drill Hall premises.

Has that resulted in cost savings? What is the intention with the former Homefield site? The Minister: Obviously the cost savings have been varied depending on where they have 150

come from. We will obviously be pulling out of the Estate elsewhere. When I arrived in 2011 the Fire and Rescue Service were occupying rented premises in Elm

Tree House – they then got brought into Homefield. We also have police officers based in lower Douglas and there was a desire for economic development purposes to free up that site. So the staff from there will be moving up to Police Headquarters and that has necessitated a need for 155

extra space. So by bringing everybody together at the new headquarters, as we like to call it, we have

released revenue savings – and the next stage is about releasing capital savings. Homefield is currently on the market for £1.4 million and that will be a useful capital receipt

for Government going forward. Likewise the facility at lower Douglas, we will be moving out of 160

that and that will enable more opportunities for economic development in that area. The Chairman: Thank you. We will move onto the next point, then, which is about border control. I would like to ask Mr Speaker to …. 165

Q9. The Speaker: We are quite interested in the announcement of the consultation that you

are planning to conduct following the Chief Constable’s Report in which he raised the possibility of improving and tightening up border security, particularly the Sea Terminal; and you have announced a public consultation. 170

Identity checks for people travelling to and from the Island: can you first of all confirm just what the position is at the moment for sea travel and for air travel, and the differences between the two? And why that might be, in terms of legislation ... or any other reason?

The Minister: Well, certainly at the moment an individual can turn up to the Sea Terminal or 175

at the UK end, buy a ticket with cash and not be required to give any identification. He is required to give a name – and it could be any name, it is not checked, it is not verified – and

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then travel freely onto the Isle of Man, and then potentially onwards to either Dublin or Belfast; or the other way round. This means that the Police, looking at the list of names of people coming in on the ferry for intelligence purposes, render that work entirely meaningless because 180

there is no way of verifying that at all. Turning to the Airport many routes, but not all routes, require photo ID for domestic travel

within the United Kingdom; and certainly if you are taking in hold luggage that normally puts the requirement in there for identification. We have also identified that for sea travel between the United Kingdom and the Channel Islands there is a requirement for ID; and likewise between 185

Holyhead and Dublin there is a requirement for ID. So even though these areas are all within the Common Travel Area there is a requirement for

identification. The Chief Constable outlined in his Report what he saw as the potential advantages to national security, essentially, of introducing such measures.

190

Q10. The Speaker: The Chief Constable and the Police do have the ability to, as part of any criminal investigation, require the production of the passenger list from airlines under present legislation.

Is that correct? 195

Mr Kelly: My understanding is that is correct, yes. The Minister: It is Department of Infrastructure legislation, I understand, so I am not as

familiar with it. 200

Q11. The Speaker: So they have that power? The Minister: But, of course, it is important that if you are not required to bring ID then the

list is effectively meaningless. 205

Mr Kelly: I think I am right in saying, by the way, that the Director of Public Health also has that power, in terms of infection control.

Q12. The Speaker: Right. Would you happen to know under what legislation it is? 210

The Minister: The 1990 Public Health Act is the last ... Mr Kelly: Yes, I think perhaps the legislation you are referring to, Mr Speaker, if I can find it … The Minister: It is the Harbours Act ... 215

Mr Kelly: It is the Harbours Act 2010, I think, sections 2, 4 and schedule 1 – it is the

Department of Infrastructure legislation. Q13. Mr Boot: Are they routinely looking at that information? Because if the information is 220

there and they do not access it are we going to be in a situation where …? Mr Kelly: Do you mean the Police, Mr Boot? Mr Boot: Yes. 225

The Minister: I understand that it is considered pretty worthless on the basis that anybody who has got anything to hide can hide it.

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Q14. Mr Boot: Are you talking about on the aviation side now? 230

The Minister: On either side. Mr Boot: Either side? Right. 235

The Minister: Unless it is a route where they can require the production of ID, then it is considered meaningless.

Mr Kelly: I think we are aware that there are strong opinions about this subject on both

sides. We have seen them expressed, so we are going to consultation, I think – aren’t we? 240

The Minister: Yes, and I am happy to answer as many questions as I can, but I certainly

cannot prejudge the outcome of the consultation. But in terms of the factual questions asked so far, I am certainly happy to try and assist as far as possible.

245

Q15. The Chairman: Is the consultation being done by an online survey? The Minister: It will be out by the end of the year. Q16. The Speaker: Has the Department or the Cabinet Office – the Chief Secretary’s Office – 250

done any checks with counterparts in the UK as to whether altering the Common Travel Area in this way would be acceptable?

The Minister: We do not necessarily see it as altering the Common Travel Area inasmuch as

the Holyhead to Dublin route and the Southampton to Channel Islands routes are also within the 255

Common Travel Area, and yet require identification. I certainly think that if we were to impose passport controls that would be another thing

altogether – and that certainly is not what we are seeking to do. Q17. The Speaker: That is probably quite an important distinction. What do you see – to be 260

helpful in this debate – where people have concerns about congestion at the Sea Terminal or queues at a border control?

Can you just explain the difference between the two? The Minister: Obviously a passport is an international document in order to travel between 265

international borders ... unless you are in the Schengen area or in the Common Travel Area it is often required to travel. However, that is not the level of security that is required in order to travel between areas within the Common Travel Area.

However, as we have explained, there are wide variety of acceptable forms of photographic ID that are accepted on flights, for example, between the Isle of Man and the UK. I have recently 270

attended a friend’s wedding in London and was able to travel using my Tynwald ID – which is, effectively, a Government form of photo identification. It does not have any particular legal standing, although driving licences and photo ID such as that would be wholly acceptable for the purposes of this sort of exercise.

275

Q18. The Speaker: But the requirement for ID by the airlines is a company airline policy. (The Minister: Yes.) The standards are not set down by Government.

Are you saying that similarly with sea travel it would be up to the ferry company to specify what would be acceptable ID for their internal purpose? 280

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The Minister: I think we would specify what forms of ID were acceptable if we were to bring in regulations on identification.

Q19. The Speaker: But at the moment, unlike the airlines, they see no need for having ID for

their passengers – the security aspects are somewhat different. 285

The Minister: Certainly in addition to driving licences we have also considered things such as

an armed forces identity card, police warrant card, security identity passes, proof of age cards; and equally looking at the exemptions for children who may not have a standard form of photo ID – although old age pensioners’ bus passes, for example, with the photo ID it would probably 290

also be perfectly acceptable. So we are not looking at passport controls here, what we are looking for is people to take

some steps to verify their identity, which we believe will have enough of a deterrent effect to at least disrupt the on-off-Island criminal activity.

We are not naive enough to think that it will be a cure-all. 295

Q20. The Speaker: So just to be clear, the checks would be made by the ferry company

personnel, not by border security agents? The Minister: Well, that is not entirely clear inasmuch as port security staff, I think, are 300

currently involved in the process and are employed at both the Airport and the Sea Terminal and could be used for that purpose. That is yet to be determined.

Q21. The Speaker: And the legislation, do you believe, currently exists to enable routine

collection of personal identity in this way? 305

The Minister: The data is already being collected and what we are saying at the moment is

that its accuracy is highly doubtful. The operators already collect data for the purpose of passenger travel. We have clear gateways to access that data for the prevention and protection of crime through the data protection legislation. 310

So, yes, I am comfortable that is all there – but it is about making sure that whatever we take out of that would be robust and sensible data.

Q22. The Speaker: So there would not need to be any legislative change? 315

The Minister: There may be legislative change in order to require the provision of photographic identification.

Q23. The Speaker: Is the Department familiar with the Immigration Amendment Order that

came in in 2011, that gave the Lieutenant Governor power for the collection and provision of 320

passports and other photo ID on areas of domestic travel; and for that information to be used to alert the relevant agency – Police, Customs or Immigration? And also, that this power actually exists at the moment but, as a matter of policy, the routine data is not collected?

The Minister: And the fact that is in an Immigration Order implies that it is more about 325

control of immigration and nationality in terms of its primary purpose anyway, in terms of the prevention and detection of crime.

Q24. The Speaker: So we are talking about data being collected routinely to a certain

standard, that Government would specify, by the ferry company in the same way that airlines 330

collect their passenger information? But that it would not necessarily be linked to an e-Borders

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control setup or transmitted to Immigration, and it would be made available to other agencies like the Police, on request?

The Minister: It would not necessarily have to be that, at all. 335

Q25. The Speaker: What would you see it as then? The Minister: Well, as I say, at its simplest level it is making sure that the information that the

travel operators are putting into their systems is actually accurate, by virtue of verifying it 340

against photo identification. Whether it joins up to any border system – which has been much debated and controversially

so – in terms of the Common Travel Area in the UK, and how it would slot into that would be a separate discussion, I would feel.

345

Q26. The Speaker: I just wonder how valuable that is going to be? Electronic verification of passports is one thing, but the use of other forms of photo ID which

can be easily forged or misused … What is going to be the value of this exercise unless we are absolutely strict on the standard of photographic ID for it to have any worth?

350

The Minister: That is why I said earlier there are certain sorts of ID that we thought would be likely to be acceptable – we are not going to allow library cards and things like that.

We need to have a certain standard and that is why the ones I identified tend to be Government-issued forms of identification – at least Government has undertaken some checks about the individual as to their identity. 355

Q27. Mr Boot: Obviously there are cost implications bringing this in. Following our earlier item on reducing costs and where you are at the moment: have you

thought about the resource necessary to do this? 360

The Minister: We have thought about it. There is a cost-benefit analysis inherent in the exercise and that will be subject to the consultation programme.

It is not that there will not be any costs, but I should imagine that most of the costs will have already been incurred. There will potentially be greater manpower costs in terms of the length of time to queue, but whether you need additional people in order to deal with those queues or 365

not ... We will need to get the evidence on that as it moves forward. Q28. Mr Boot: And a slightly different tack: what is the situation with private boats coming

into the Isle of Man waters and docking at Peel, or wherever? 370

The Minister: Any boat that comes from off Island, unless they have come from outside the Common Travel Area, is not required to notify the harbour master about who is on the boat. They will be required to notify the harbour master in order to pay their harbour dues, but nothing more than that.

So this would need to apply to that as well, in terms of boats coming into the Isle of Man who 375

did not come originally from the Isle of Man. If you were just out for a day trip fishing, for example, round the Calf of Man – a beautiful part of the world – and if you leave from Port St Mary and you come back to Port St Mary you are not going to have to do any information requirements.

Equally, it also depends how rigid you want the system to be. In terms of the number of 380

pleasure craft that come to the Island, it is not going to justify a whole bureaucracy around that; but it does not mean that the legislation should not apply, because that would be an obvious loophole.

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In terms of how it is applied there are potentially large elements of flexibility in there around making sure there is a notification, and then anyone who deliberately tries to avoid making the 385

notification ... that in itself would raise questions. Q29. Mr Boot: I think there is a weak link there and there may be a resource implication,

particularly with the number of ports we have? 390

The Minister: Yes, although our ports in the main are covered by CCTV so you would be able to identify whether vessels and people have come and gone; and, as I say, what I am trying to prevent is certainly even proposing something which would be unnecessarily bureaucratic or rigid.

So it could be that if you were on a fishing boat out of Scotland and you are going to stop off 395

for a night in the Isle of Man, just an e-mail or a message to the relevant harbours control room or harbour master in Douglas, say, would be adequate. There does not necessarily have to be a set form that has to be stamped 27 times and gone through a load of pre-approval and bureaucracy. It is a matter of maintaining our flexible stance whilst enforcing the legislation.

I would just say that these are the way that things could be done – 400

Q30. The Chairman: Yes, you are in a consultation? The Minister: We are not even at the consultation stage yet, but it was just to demonstrate

the way that we have thought about some of these issues. Inevitably there will be more – and 405

there will be things that we have not thought of – and that is why we go out to consultation in the first place.

Q31. The Speaker: Just to conclude it would be wise, would it not, before embarking on

consultation just to identify the limits of what is possible within the Common Travel Area 410

arrangements? The Minister: Absolutely, and that research is ongoing at the moment. Q32. The Speaker: And those discussions are taking place with the UK, are they? 415

The Minister: I have not been personally involved in any discussions with off-Island

authorities but, as I say, this consultation paper is being drawn together at the moment. Q33. The Speaker: By your Department or ...? 420

The Minister: By my Department. Q34. The Speaker: Yes, but when you are consulting ... what people say will be partly framed

and driven by the questions that are asked. 425

In the framing of the questions, what are you doing to ensure that what people would like to say will actually be possible at all? Let’s say some people think that full-blown e-Borders passport control would be a good idea and we think that is impossible under the CTA arrangements at present.

What steps are being taken to identify with the UK what would be possible under the 430

Common Travel Area, and whether unilateral action will be possible? The Minister: This is a consultation on what people would like – and if what people would

like is achievable, then more’s the better. If what they would like will require a more in-depth

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discussion with other jurisdictions then that would be the point – and certainly before any 435

legislation came forward that would have to happen. But if there was a public mood that says that full-blown e-Borders is not the mood, then I

would not necessarily waste an awful lot of time going down that particular rabbit hole because there is no public appetite – and that is exactly what the consultation is for in the first place.

440

Q35. The Chairman: Yes, but the consultation is not going to just be based on what people would like, is it?

The Minister: No not entirely, but it is an important gauge; it is not just about what people

would like, it is also about the practicalities. It is important that we do gauge public views and by 445

trailing the consultation some of those have already come forward. Q36. The Chairman: Thank you. We move next onto policing, and perhaps you would like to tell us what has been the impact

of recent cuts on visible neighbourhood policing – or is it too soon to judge? 450

The Minister: It is hard to tell because there is an easy way of doing it and there is a more

sophisticated way of doing it – and the easy way of doing it is just to look at the crime figures. But actually as has become more apparent to more people in recent months, the crime figures only tell one side of the story – and one side of what is a complicated and diverse job of being a 455

police officer. Last year we saw a 9% increase in crime – that was a 194 offences, I think; so we are very

much dealing with the law of small numbers here. This year on the whole, we have seen relatively flat crime figures, and in fact year-on-year to the end of October showed that crime was down on last year – which is welcome. 460

And given that we have had reductions from a peak of round about 240 officers, down to the present establishment of 211 – and in reality being under that, as people have left and we are trying to keep up with recruitment, because the budgetary challenges have not allowed us to recruit in advance as we once did. That has presented challenges for most of the teams in policing, whether they be neighbourhood teams, or CID, or road traffic … there have been a 465

number of knock-ons to that. However, officers have really stepped up to the mark and played their part by going over and

above in order to make sure that they have provided an effective service to the public. I think that is represented in the satisfaction surveys that are measured and are still hovering around about the 90% mark – which I think is an indication of general public satisfaction in policing. 470

Q37. The Chairman: There are several different statistics, aren’t there? There is reported

crimes and there is also – where we have always had a good statistic – in terms of crimes that you identify and are completed … ?

475

The Minister: The detection rate? Yes. The detection rate remains high at about 45% to 50% which, compared to the UK average of

nearer 25%, is a fantastic achievement on behalf of the Constabulary. Q38. Mr Boot: In terms of crimes and reported crime, is there any estimate of unreported 480

crime, minor crime? The Minister: It is very hard, we do not do a National Crime Survey in the way that the UK

does and they have a gap between the reported crime and that figure.

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But we do sense that there are areas of under-reported crime, certainly domestic abuse 485

would be one area that we have always felt has been historically under-reported. Sexual offences, again, we have felt have been historically under-reported.

So, as we have seen in the last year or year and a half, increases in reports of domestic violence, increase in reports of sexual abuse – particularly historic sexual abuse. I think that says a lot about confidence in the Police Force, that people do feel they are being listened to and that 490

their crimes are going to be investigated properly; and we have had some good prosecutions recently that have demonstrated that as well.

So yes, I think they have been under-reported and I think as public confidence continues to grow in policing – and indeed as we have seen victims increasingly come forward and break the taboo in some of these areas – it is only going to be a healthy thing for society as a whole, and 495

policing as well. Q39. The Speaker: In relation to that there is the issue that, across, unreported crime has the

effect of distorting the overall figures … people simply do not bother to report crime because they do not have the confidence that the Police will take it seriously and bother to investigate it 500

– so there is a lot of unreported crime. Do you see any of that situation here? The Minister: I think a key difference between us and the United Kingdom is borne out in

comments, for example, as Peter Fahy who was the Chief Constable of Greater Manchester 505

Police quite openly confessed, only about one in five of the crimes reported were going to be investigated. If you heard that, as a citizen in Manchester, you would quite rightly wonder what the benefit was in reporting your crime, especially if it was of a minor nature or public order nature – you would wonder why you should bother.

That is why we have been consistently giving out the message in the Isle of Man that if you 510

report a crime it will be investigated. All crimes will be investigated. There is not this system that happens in a lot of UK authorities where they are simply triaged out.

We are still committed to investigating every crime that is reported to the Constabulary – and long may that continue.

515

Q40. The Speaker: Does the situation with your resources mean that cases which have not been closed off – the investigations are still open as it were … thinking of cases of harassment of people, or anonymous threats to people which are ongoing.

Is there a sense that the Police do not have the resources to follow these up, perhaps in the way they would like to liaise with the victims in these cases on an ongoing basis … reporting back 520

and giving information? Are the Police just snowed under with other stuff so that they cannot do that? The Minister: I think it is fair to say when you look at the satisfaction statistics for policing …

of the 10% that are less than completely satisfied with the service they have had, the most 525

common cause is that they do not feel they have had timely feedback on the case, or on the progress of the case. I think that is due to the fact that investigating crime has come before information and communication to victims and witnesses.

That is not something I welcome. I think that is something that when we get up to full establishment should fall out of the current difficulties; but I think it is a product of where we 530

are in terms of running short between our present police establishment and the number of police officers that we actually have on the ground at the moment.

Q41. Mr Boot: Has anti-social behaviour gone up with less neighbourhood policing? What are the statistics showing there? 535

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The Minister: My understanding is that anti-social behaviour, certainly public disorder offences, have dropped quite dramatically in the last year. If you take that as a barometer I think that is possibly more to do with the decline in the night-time economy, but in terms of across what they class as anti-social behaviour they have fallen by about 10%. 540

Q42. The Chairman: You referred to historic cases of sexual abuse, for example, and one of

the current concerning features of our modern society is online bullying and crime which may lead to people ultimately taking their own life.

Have you considered legislation in that regard? Are we making any progress? 545

The Minister: I have certainly met with relatives of people who have been driven to commit

suicide as a result of online crime, online bullying. It is something that is an ongoing situation and nothing particular has been identified at this point in time that would dramatically change things in terms of a legislative fix. 550

We have undergone significant changes in policing and will continue to do so over the coming year around online crime and how we police things. Certainly police mobile working is something that is still developing through the digital strategy.

In the last year or two we have developed a digital crimes approach and that is something that should see benefits. But also taking it into wider fields of joint working, one of the key 555

themes for the Safeguarding Forum for 2016 will be online safety. And something I am certainly very keen to do is make sure that victims and their families are heard in that debate. So the professionals can hear it from the victim’s perspective as well as from the professional or the academic perspective, or from purely just looking at a page of statistics – because that really brings home the tragedy of what these faceless crimes can be like. 560

Q43. Mr Boot: Can I just take cybercrime one step further, as it were. The UK banks and credit card companies now investigate online – credit card or debit card –

fraud. What happens here? Do the Police still investigate? 565

The Minister: I am not familiar in terms of the details about who does what and where, down the cycle.

Obviously the Financial Crime Unit do deal with a myriad of financial offences over the course of the year – everything from taking in anti-money laundering, putting in suspicion reports, through to major thefts; and online crime is part of that. But in terms of how they deal with 570

banks and their own internal investigations I am afraid I just do not have that level of detail, I am sorry.

Q44. The Chairman: So the Financial Crimes Unit still does exist, despite what I might have

heard recently? 575

The Minister: Yes. The Chairman: Good! I am pleased to hear that. 580

The Minister: Don’t believe everything you hear! Q45. The Chairman: I am jumping around a little bit here, but I also heard recently that

somebody suggested – and I am jumping back – neighbourhood policing is effectively dead. What would your response be to that? 585

The Minister: I could not disagree with it more, it is the first item in my Policing Plan. I am

conscious that the Constabulary constantly have to balance neighbourhood policing with all the

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other things that they have to do … and they are many and varied, inasmuch as the Isle of Man Constabulary have to provide all the services that Greater Manchester or the Metropolitan 590

Police have to achieve – but with a far smaller number of people, and far fewer specialists, and a far greater number of generalists.

Neighbourhood policing is still absolutely at the core of the Manx policing model and it has been a key part to make sure that continues. And when we get the present cadre of trainee officers out of the classroom and onto the streets, it is important that they will be in 595

neighbourhoods under tutor constables. Q46. The Chairman: Good, thank you. What has been the impact on the Police of recent cuts in mental health services? I was present when the Chief Constable briefed Tynwald Members and he did refer to this 600

subject. So could you bring us up to date on that? The Minister: I am going to have a rest and let Mark have a turn. Mr Kelly: I am always slightly reluctant, Chairman, to talk about other Departments, because 605

this obviously is not our Department – mental health resides in Health and Social Care. I was a little surprised to see the cuts in Mental Health Services because my understanding is

that perhaps the resources might be increased in that area – I am not certain about that. But certainly the Chief Constable has highlighted that for his officers, around about a fifth of

the cases they come into contact with involve someone with a mental health problem. He has 610

raised it with me and with the Minister as a major issue that he wants us to consider. I had a meeting with the interim Director of Mental Health Service, Angela Murray, and

Malcolm Couch the new Chief Officer of Health and Social Care, with the Chief Constable. And Gary Roberts has tasked one of his officers to work closely with Angela Murray to establish a working group to get some practical solutions on the ground. 615

Obviously we want a strategic solution as well and there will be a Mental Health Strategy coming forward to Tynwald quite soon I believe; but actually we have got problems now and they need to be addressed now.

So they are going to work very closely together to address that area and hopefully we will see an improvement in the near future. 620

The Minister: The Mental Health Strategy has been approved by the Council of Ministers so it

will be coming in very soon. Q47. The Chairman: Good. 625

I have to say my understanding was that resources were going to be applied to Mental Health Services – long overdue perhaps – rather than cuts; but it is an issue which even public representatives can find themselves involved in, and it is a really difficult and challenging area. So the work in terms of joined up is … ?

630

The Minister: Absolutely. Certainly we are all aware that budgetary pressures are there, even if there is more money

available to the Mental Health team, the addition of the strategy is there intending to make sure that the services grow together rather than grow apart as money becomes more of an issue.

635

Q48. The Chairman: What is the rate of referral of children from Police to Social Services? The Minister: I am pretty sure that is a matter that is down as a Question next week in

Tynwald – I would hate to prejudge a Tynwald Answer. 640

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Q49. The Chairman: Okay, that is fine – good for you for acknowledging that protocol. Then I will leave the supplementary that I had.

Assuming that the Police (Amendment) Bill 2015 goes through, what plans have you developed from contracting out services which are currently delivered by police officers – and I am aware that is before the branch as well? 645

The Minister: That is right, but in terms of the policy there, certainly we have not gone too

far down the line of going out and contracting services because we cannot take it for granted that the Bill will pass – and certainly not what form it will pass in.

We have explored the idea of the custody suite being contracted out in the same way that 650

custody is contracted out at the courts and prisoner escorts are contracted out. So we do feel that there are opportunities there and there is a track record of success in this area for contracting out.

Mr Kelly and myself have been to Lincoln and seen how this works on quite an expanded contract down there, which not only means that custody is provided by civilian staff working 655

under police supervision but also in outreach places around the community. And once an arrest is made the private contractor even provided a cell van so that people did not have to be taken all the way back into the central of Lincoln to be processed. On a Friday night you wait until the van is full and then take the van back to Lincoln; you can be taking three or four, or maybe up to six prisoners at a time back to the custody cells rather than tying up a team of, potentially, two 660

officers and a car every time somebody is arrested. So it is about thinking more tactically … clearly the distances in Lincoln are far greater than

the distances in the Isle of Man, but these are very practical considerations and things that could be looked into further should it come to that point in the cycle after the legislation has passed.

665

Q50. The Chairman: But it is not a wholesale privatisation of the Police, as I have heard described by some?

The Minister: No, Mr Houghton’s colourful comments were wildly inaccurate and I did not

recognise the sort of model that he was portraying. 670

There are many safeguards in this, inasmuch as not only does it require Tynwald approval but it requires Tynwald approval in quite a lot of detail in terms of what service will be contracted, how it is to be contracted out, the number of people and what powers these people will have.

So there are quite strong safeguards identified in the Bill that would prevent any move to contract out elements of policing that people were not comfortable with. And certainly I have 675

absolutely no intention whatsoever of bringing in a Police Community Support Officer as a substitute for police officers on this Island. That certainly would have a major dent in public confidence were that to come to pass.

But there are areas of specialist policing where this could be looked at elsewhere. We already employ, for example, former officers with detective skills, on zero hours contracts, to support 680

investigations. So there are other opportunities to look at how contracting out could work better within our model; but still when people phone the Police they will get the Police.

Q51. The Chairman: Thank you. We will move onto the Fire Service next and I hope you are able to answer this … 685

You are coming to Tynwald next week with the financial motion for a live fire training facility. Why do you need to spend this money?

The Minister: Well, we are asking Tynwald for £557,000 of taxpayers’ money and I am

absolutely confident that this is required. 690

It is required for a number of reasons but the primary reason for it is firefighter safety. We spend around £50,000 a year sending firefighters off-Island to do a course that with this facility

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we could do on-Island. This facility would last for about 20 years and it can be operated by local staff. It is a fantastic reduction in terms of the cost base for the training as well as having the added advantage of not requiring officers to go off-Island – or to be paid to be off-Island for 695

retained officers, and therefore effectively taking two appliances-worth of staff out at any one time in order to go through training.

So, as I say, for financial reasons, for safety reasons and for good HR reasons … that is why I would say the facility will be a real asset to the Island.

700

Q52. Mr Boot: Can I ask, do we already have people on the Island who are qualified to be instructors or are we going to have to bring people across?

The Minister: I am not aware if we currently have people trained as instructors but certainly

the plan would be that people will still have to go away to do this, but far fewer people would be 705

going away. They are doing the ‘train the trainer’ type of approach and then they can come back and train everybody else.

But there will be a need for a certain level of off-Island training just to make sure we are maintaining consistent standards with the UK.

710

Q53. Mr Boot: And that is costed into this? The Minister: Yes. Q54. The Chairman: We understand that the Fire Service routinely makes recommendations 715

to business owners about fire prevention measures such as sprinklers etc. To what extent are business owners obliged to follow the Fire Service recommendations?

The Minister: It depends on whether we are talking about recommendations or applications

of legislation. 720

We have things such as the Fixed Firefighting Regulations so any building over 5,000 cubic metres for example, needs to comply with the Fixed Firefighting Regulations. There is a requirement then for a fire management plan and so on in that. There is a difference between recommendations and actually just application of the law as it stands.

725

Q55. The Chairman: But in terms of recommendations? The Minister: I think the recommendations are there to ensure public safety and it is advised

by the Fire and Rescue Service that certain aspects of your premises need to be improved. You are taking a serious risk in terms of your own liability should you fail to follow them and certainly 730

that would have an impact with insurers – and not to mention, potentially, unions and others who are there to look out for the staff.

Q56. The Chairman: Good, I think we are onto the last item … unless there may be an ‘any

other business’. 735

The Minister: Am I boring you? The Chairman: No! 740

Q57. The Speaker: Can I just ask one thing on the Fire Service? Last year when you met the Committee you were able to give some assurance about the

future of the regional network of fire stations and retained firemen. Is that still remaining the situation?

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The Minister: Yes. 745

Q58. The Speaker: Would you care to elaborate? The Minister: It serves me right for giving a straight answer in politics, doesn’t it! Yes, the model of regional fire safety in terms of the present mix of full-time officers and the 750

retained officers around the fire station network as it exists remains unchanged, as in our target operating model.

Mr Kelly: We have had advice from the Scottish Inspectorate who come over, we dealt quite

closely with them, and they feel that is definitely the way to go. 755

Q59. The Speaker: So, they have endorsed the strategy? Mr Kelly: Yes, they have. 760

The Speaker: Thank you very much. The Chairman: We like straight answers but you know – The Minister: You are just not used to them! 765

It always has the advantage of surprise in politics, I was told. Q60. The Chairman: Well, occasionally it could be perceived by some as being a little

arrogant – but not for a moment would that be the case here! The single legal entity proposal: the idea of Government as a single legal entity was debated 770

in Tynwald in November 2014, and the Council of Ministers was asked to report with recommendations by June 2015. In June 2015 the Chief Minister did not report with recommendations but instead launched a consultation.

What is the latest position? And what implications would this proposal have for the Department of Home Affairs? 775

The Minister: My understanding is that the response to consultation is yet to be published by

the Cabinet Office. Mr Kelly: It is still ongoing, I gather. 780

The Chairman: Okay. Q61. The Speaker: The Department of Home Affairs will exist in a different form under a

single legal entity, won’t it, and the lines of political and financial accountability will be 785

different? Will they be better? The Minister: It would depend on how it was to work. I have not seen the response to the

consultation so I could not say which model, of many, that you could draw up under a single 790

legal entity. Q62. The Speaker: Is the Scottish model – one which has been in about seven or eight years –

one that is likely to be followed? 795

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The Minister: Well, I understand that the Scottish model was the inspiration for asking the question, but I do not know necessarily whether any one particular model will be plucked off the shelf. I think there will inevitably be differences in the Isle of Man.

Q63. The Speaker: A lot of the changes there that have been brought in in policing and social 800

service provision in the good name of ‘streamlining government’ and ‘joining up’ aspects of government has meant … for example the centralisation of regional police forces into something that has turned out to be disastrous in some senses. And it was the single legal entity way of governance, of breaking down the silos, that has been responsible for that.

I just wondered what, if any, misgivings you might have? 805

The Minister: Well, I think we already have a very successful single national police force – it is

one that as yet is not going out to local authorities. However, I think there are areas there that would be different. The present relationship

between the Minister of Home Affairs, as it stands, and the Chief Constable would by necessity 810

have to change if there was a single legal entity in Government. Certainly in Scotland that has meant a greater insulation between politicians and the Chief Constable, whereas my role is one of direct engagement – the writing of a Policing Plan and the holding to account directly of the Chief Constable.

My understanding is that in Scotland there is now a body placed between them in order to 815

make sure there is that insulation. So that would obviously be a resource requirement in there and we would have to see … But this is somewhat a matter of conjecture at this time, to see what comes out of the consultation and then what, if any, changes will happen going forward.

The Chairman: Well, I think we are almost there. 820

Thank you for your frank and concise responses and from the Committee’s point of view we would like to place on record our thanks during challenging times for the ongoing work of the Emergency Services which the Island obviously appreciates.

At this stage the Committee will now sit in private. Thank you. 825

The Minister: Thank you, Chairman Mr Kelly: Thank you, Chairman.


161161

162162

13th April 2016 Evidence of Hon. T

Crookall MLC, Minister, and Prof. R

Barr, Chief Executive, Department of

Education and Children

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O F






D A A L T Y N


DEPARTMENT OF EDUCATION AND CHILDREN

HANSARD

Douglas, Wednesday, 13th April 2016

PP2016/0068 SAPRC-EC, No. 2/15-16



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STANDING COMMITTEE, WEDNESDAY, 13th APRIL 2016

__________________________________________________________________ 28 SAPRC-EC/15-16

Members Present:

Chairman: Mr D C Cretney MLC Hon. S C Rodan SHK Mr G G Boot MHK

Clerk:

Mr J D C King

Contents Procedural ...................................................................................................................................... 29

EVIDENCE OF Hon. T Crookall, Minister, Prof. R Barr, Chief Executive, .............................................

Department of Education and Children ......................................................................................... 29


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Standing Committee of Tynwald on Social Affairs Policy Review




[MR CRETNEY in the Chair]

Procedural

The Chairman (Mr Cretney): Welcome back to this public meeting of the Social Affairs Policy Review Committee, a Standing Committee of Tynwald.

Please ensure that your mobile phone is on silent, at the minimum, so that we do not have any interruptions.

For the purposes of Hansard I will be ensuring that we do not have two people speaking at 5

once.

EVIDENCE OF Hon. T Crookall, Minister,

Prof. R Barr, Chief Executive, Department of Education and Children

Q70. The Chairman: We are now going to hear from the Department of Education and 10

Children and I would like to begin by asking each of you, for the record, to state your name and job title.

The Minister for Education and Children (Mr Crookall): Good afternoon, Mr Chairman, Members of the Committee. I am Tim Crookall, Minister for the Department of Education and Children. 15

Prof. Barr: Good afternoon, Chairman. I am Prof. Ronald Barr and I am Chief Executive of the

Department of Education and Children.

Q71. The Chairman: Thank you and welcome. We last heard from you on 15th October 2015. Would you like to make any opening

statement on how things have been going since then? 20

The Minister: Thank you, Chairman. I have to say things have progressed fairly satisfactorily within the Department, all things

borne in mind with regard to funding and those sorts of things. Staffing has been a bit of an issue, certainly within the hub at Hamilton House. We have had

several changes for whatever reason: retirement, sickness, which have caused us one or two 25

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issues trying to sort those out. But the staff, as they do right the way across Government, all pull together in a time of need and we are coping.

Across the primary and secondary schools and the College, again, with such a big organisation, with such a lot of employees, full-time and part-time, there have been issues there. But we continue, I believe, to provide what we are told by outside sources and what we 30

believe ourselves to be a very good service, sir.

Prof. Barr: Do you want to say about the NSC?

The Minister: Yes. I have just been reminded by Prof. Barr, we are all well aware of 3rd December, the storm that affected the NSC. That was the biggest part of our portfolio that was affected. We believe at the moment it was somewhere around about £2.5 million/£3 million 35

worth of damage that was done there. As you may be well aware now, the outside facilities are all back online except for the high

jump and the long jump pits; we are just waiting for the cushions there to go back in. The indoor sports centre: the floors there are due to start going back down in the very foreseeable future. We hope to have that back very soon. 40

Q72. The Chairman: Okay, thank you. When we met in October we asked you about cost improvement. Please can you remind us

of the overall budget of the Department?

Prof. Barr: The budget of the Department is about £92 million. We are continuing to make year on year savings. 45

This year Treasury has allowed a 1% increase in the budget to accommodate pay rises; in the previous financial years those have had to be accommodated within the Department's existing budgets. Those are in the order of between £0.5 million and £600,000, so those have been fairly challenging numbers to meet over the last three or four years.

Beyond that, we have been doing various other things to move forward cost improvement. 50

We recently launched the new university college of the Isle of Man and that is part of a medium-term strategy to save Government, by about 2020, about £1.5 million as we grow more and more higher education to be delivered on Island.

We have a range of other things that we are also looking at in terms of teaching assistant provision across schools and the introduction of a new student award system to provide online 55

applications and reduce back office functions, and there are a number of other initiatives as well which are currently on the go.

Q73. The Chairman: So presumably you are content with what was voted to the Department in the Budget?

Prof. Barr: I thought – 60

The Chairman: You could always want for more, but that is – Prof. Barr: I think it was a very fair settlement. I think Treasury do their best under difficult

circumstances. We are confident that we will be able to meet our obligations in this financial 65

year. Q74. The Chairman: Okay. We have talked over the years about delegated financial management and the centralisation

of services. How are you finding the new centralised service regime? 70

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The Minister: Shared services, Mr Chairman, are working in most areas. We have had issues with some of those. We try to work through those; the schools try to work through those.

The latest one is the fleet shared services with the minibuses and things. That is ongoing at the moment. It is basically in its infancy, so we will see how that one pans out between 75

ourselves and DoI. The issues that we had last time we met with regard to the cleaning and the caretaking side

of things, I believe is getting better. So, yes … 80

Q75. The Chairman: How about Payroll, Human Resources and Estates? How is that? Prof. Barr: I think – if I can just say – with GTS on the IT side, that is working well; I think also

in OHR, where we centralised the OHR functions. There are some operational issues with Jobtrain which I think all Departments have been struggling with, but by and large that has 85

worked well. Caretaking and cleaning is bedding in well. We are not receiving a lot of adverse comments

from either parents or from schools or the College with regard to those. Q76. Mr Boot: I have done some school visits just recently and, talking to the heads about 90

centralised financing, I think they preferred to have more control over what they are doing. So my question is really – as I am fairly new to this – has the centralisation cut costs? What is

the idea of the centralisation? The Minister: If it has cut costs? (Mr Boot: Yes.) It has taken some of the expenditure away 95

from the schools with regard to the cleaning, the caretaking and the catering. Those have all gone back to DoI, so they have not got that budget any more to deal with themselves.

Q77. Mr Boot: But they lose the flexibility then of dealing with it in-house. 100

Prof. Barr: If I may say, Mr Boot, the whole purpose of shared services was to reduce overall Government expenditure. Obviously it is something which is quite a significant change. There is clear evidence that centralisation – for example, of IT contracts – has saved Government significant money. There is an ongoing review of shared services which is due to report back sometime later this year on how successful it has been. There are saving targets attached to all 105

of these in terms of – Q78. Mr Boot: The question is premature, really? Prof. Barr: Yes. The evidence to date, as far as Chief Officers are concerned, is that there 110

have been savings achieved through shared services, particularly in relation to IT contracts but not exclusively.

Q79. The Chairman: You told us last time that you were working on a proposed Education Bill

for the next House of Keys. Could you remind us why you need the new legislation and how that 115

work is going on? The Minister: Yes, we certainly are still working on that, Chairman. John Gill, the former legal

man in the Department, retired last July. We brought in Andrew Shipley who is now, once he has settled in and sorted out one or two other issues within the Department … He has now picked 120

up that mantle. We are hoping to bring that forward in the year 2017-18. Obviously that will have to be drawn up there in draft and go out to Members; it will go out to full consultation. Hopefully, we will have that in the 2017-18 year.

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Q80. Mr Boot: Why do we need the new Bill? 125

Prof. Barr: Because the existing Bill is somewhat dated and there are items in it which need to be refreshed, particularly with regard to provision of things such as religious education.

There are also issues with regard to pre-schools and the fact that we have no statutory ability to issue any kind of educational inspections within the pre-school private sector provision.

There are a range of other items such as that that the Department needs to really bring 130

forward, which we can only do through statute. I notice you have also got the Education Council on here. Again, that is something which the

Department is looking at, ultimately to perhaps remove and replace with an independent ombudsman to handle complaints which are brought against Education, sports and the arts, which we are responsible for. In our view, that would be more cost-efficient and more 135

independent than the current Education Council. But we cannot move on a lot of these things unless we have primary legislation.

The Minister: Also – sorry Chairman – on the back of that, catchment areas are an issue to

the Department and that will be included within the new Education Bill. 140

Q81. The Speaker: Is it intended the Education Bill will be the vehicle for any functions that

you may have in relation to your responsibilities for children? You are still the Department of Education and Children. Of course, a Children's Bill was, in 2010, going to be on the cards before it was dropped. 145

Is what we are talking about purely educational services, core services of your core function, and not in respect of cross-departmental interests in children – wellbeing, for example?

The Minister: Yes, the title ‘Education and Children’ does not really tell the tale, Mr Speaker.

‘Children’ is a redundant part of the title. It does not carry any weight, if I can put it like that. It is 150

actually quite embarrassing at times when people say, ‘What do you do with regard to children?’ We do education, but the ‘Children’ side tends to come more under the Social Services’ side of things rather than us, although we obviously work with Social Services. We educate children, but that is only the education side of it.

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Q82. The Speaker: It does rather highlight that you are the lead Department of Government for children's welfare across the board.

Prof. Barr: I think there is a sense of confusion there, as the Minister has indicated. The

correct title for the Department really ought to be the ‘Department of Education, Sports and the 160

Arts’ or ‘Sports and Culture’. For cost reasons and other reasons, a determination was made not to change the Department name.

It is confusing, particularly when we go to other jurisdictions, and it does, I think, on Island, blur the statutory responsibilities in terms of children's services, which actually sit far more with Health and Social Care from a statutory point of view than they do from Education. 165

The Speaker: Thank you. Q83. The Chairman: We just spoke about the Education Council that has recently been

appointed. When does that term of office cease? 170

The Minister: That is a three-year term now, Mr Chairman. Q84. The Chairman: Three years. So are you hoping that the proposal for an ombudsman

may coincide with that? Is that what the plan is? 175

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Prof. Barr: That was the plan and that is why it was drafted in that way. Q85. The Chairman: Some people may suggest that the Board of Education was a more

democratic organisation than what we have now. Do you have any views on that? 180

Prof. Barr: My own view is that the Education Council is a very laudable organisation and contains people who are obviously genuinely interested in education, and the Minister and I and other senior officials meet with them on a regular basis. However, the reality is that it is not really truly independent because those meetings are chaired by the Minister. I think that is why I say that actually if we are really being truly accountable, you would move to something that was 185

far more independent than that. The individuals concerned are not in the pocket of the Department, but I do think from a public point of view and from a political point of view a much clearer delineation between the two would be better.

Q86. The Chairman: Okay, thank you. 190

What progress have you made on developing educational standards for preschool settings? You have referred to that; again, that is something that is going to be in the Education Bill, yes?

Prof. Barr: It is, but we do have a number of initiatives that are on-going in terms of

preschool education. We are liaising very closely with the Registration and Inspections Unit of 195

Health and Social Care. That roughly takes place every half term. We have reached agreement with DHSC in principle that joint inspections with both Departments would be the right way forward.

We have been looking at leadership in terms of Registration and Inspections as well. We have a planned training day organised by Department of Education and Children in May and also by 200

the Education Improvement Service on early years, and that is going to be led by former HMI inspectors in early years education.

So we are trying our best where we can, without having the legislative framework and the statutory framework to do so, to try and engage in this space.

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Q87. The Chairman: In terms of the inspections that you have just referred to where you have an agreement with the other Department, wasn’t that the case last time you came? So it is still taking some time to get …?

Prof. Barr: It cannot move forward, Chairman – 210

Q88. The Chairman: You require to have legislation? The Minister: – unless we have the Education Act. That is one of the key elements within any

new legislation that we are bringing forward. 215

The Chairman: Right, okay. The Minister: But they do have a very good working relationship between the two, or the

officers involved now, Chairman. I must say it is much better than it was originally and it is 220

working. Q89. The Speaker: Is that on the basis that preschool education is not a statutory

requirement? You have general powers to make schemes for education, and inspection could be part of that. Is it because it is preschool? 225

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Prof. Barr: It is preschool and it is in the private sector, in the same way that we have no statutory powers to inspect King William’s College. That is the issue, in the sense that we would need to have that framework.

We tried to actually see if it could be tacked onto the existing legislative framework within 230

Health and Social Care, and they tried their very best to help us with that but there was not a way forward with that, so it has come back to it needs to be part of the new Education Act when you bring it forward.

The Chairman: Okay. 235

Q90. The Speaker: You talked about inspection of private institutions. Are there any plans to

go wider than that in ensuring parents carry out their duty of educating their children? That is a general duty; your duty is to provide the schools for those that want them.

240

Prof. Barr: There are no plans to do anything with regard to those who choose to home-educate their children other than what the current situation is where they have to register, but that is what they are doing. We have no plans to move in any other direction with that.

But you are talking about going wider. The one area that again I think needs to be included within a new Education Act is where we have private sector providers – and I have referenced 245

this to the Committee before – where we have, potentially, people coming in and offering educational courses in the private sector. There have been cases in the past where that has not been very successful in the Island and has damaged, I think, sometimes, the educational opportunities of young people.

I think we know from immigration and from other bodies across Government that there are 250

many people who come to the Island and make offers of setting up private education establishments – all kinds of things like that. Actually, if such things are set up, how are we going to reassure ourselves that they are actual operating to the required standard and not damaging young people and actually causing reputational damage to the Island? (The Chairman: Absolutely.) Again, that is something that probably needs to sit in any new primary legislation. 255

The Speaker: Thank you. Q91. Mr Boot: How many people are actually home-educating at the moment? 260

The Minister: It is about 40, I think. That figure has been fairly stable for quite some years now, but we think it is round about 40.

Q92. Mr Boot: Do you monitor their results in exam terms or anything? There is nothing

going on there at all? 265

The Minister: No. Prof. Barr: No. 270

Q93. The Chairman: Have you been able to make any progress in identifying special educational needs early in the context of the new preschool arrangements?

The Minister: Yes. We have an arrangement with the preschools, Chairman, where they have

access to the Preschool Assessment Centre. If they think there are any issues, they are more 275

than welcome – in conjunction with the parents and the children involved – to make use of that facility.

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Q94. The Chairman: It is very appropriate that the next question … With all its faults, the previous arrangements did, to an extent, concentrate the preschool provision in what may be 280

described as more deprived areas. Has there been any progress in terms of redressing that balance?

The Minister: I have to say, Chairman, that – and it obviously depends on what you would call

a ‘deprived area’ – when the offers went out to tender, for most of those areas which I think you 285

are probably talking about, there were not any offers that came in for those areas. That does not mean to say that we have not been working and talking to people with a view to – in the next year, when we go back out to tender – hoping to provide something in there, or somebody providing something in those areas.

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Q95. The Chairman: That is exactly the point, I think, Minister. I have previously asked whether, in the absence of the private sector stepping up to such, it is something either the Department or the Department in conjunction with another party may seek to fill that gap, if it is not one that is financially going to stack up?

295

Prof. Barr: I think there is an issue there, obviously. What we have seen is that the private sector is taking the easier bits and the profitable bits, and that is fine. There is an issue, when you talk about ‘deprivation’, I would suggest that it is the more rural areas as well as potentially poorer areas, and it is how we manage that. I think that is an issue for Government in the sense of perhaps incentivising the private sector to do this. 300

It is either that or you are then into a position of potentially Government re-entering an area that it left to the private sector. So either of those options, I would suggest, are political but I do not doubt that we need a decision in this area because the current provision is not where we would want it to be.

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The Speaker: No. Q96. The Chairman: Good, well I agree with the last statement. Have you relaxed your catchment policy? 310

The Minister: Not at all, Chairman; if anything, we are getting tougher on it. We have to make sure that the schools are staffed properly and to the right numbers if

possible. We try to control the children crossing over the boundaries as and when we can. It is not always possible. If there is a reason to do it, there has to be a good reason. But we know there is some abuse that goes on: people say they are living in an area or moving to an area. 315

That will always go on, we think, but we are trying to curtail that and, as I said, that will be tightened up again in the new Education Bill.

Prof. Barr: We have a small minority of head teachers – and it is a small minority – who I

think would welcome a laissez-faire approach to this, but it is not the Department’s policy and 320

where that has happened it has been made clear to head teachers that is against the policy of the Department.

Q97. Mr Boot: Where a school is perhaps ‘under-pupilled’, for want of a better word – an

Americanism – are they allowed to take people from outside of their catchment area as a matter 325

of course or are they discouraged from doing that? Prof. Barr: They are not allowed to do it as a matter of course. It is something which we

manage very closely from a Department perspective, and what we need to be doing is utilising the existing infrastructure, that has been paid for by the taxpayer, to the maximum benefit. This 330

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is why we are so opposed to relaxing catchment areas, because you would have some school that is already full, that is deemed to be popular or whatever it is, and you would have a stream of people wanting to go there. We would then be under pressure to build additional infrastructure to accommodate that, while you then have school buildings that are lying in other areas which are not being fully utilised. That is not actually value for money, and it is not a good 335

use of existing resources. That is where we are. Catchment areas are very important to make sure that we can, from time to time, make

adjustments so that we are actually able to … For example, Peel Clothworkers: conceivably as more and more of those houses are occupied around Peel and young families come into them, before you would look at perhaps building additional capacity at Peel Clothworkers, you would 340

look to use the existing schools’ capacity at Michael and also in St John's. And in St John's that would then tip out into Foxdale, because you have got an existing school structure there that you can actually utilise in slightly different ways.

Once you have done that, I think the Department has a much stronger case to argue for additional infrastructure spend, but we have got to demonstrate we are using the existing 345

infrastructure effectively and appropriately. Q98. The Chairman: Okay. It is not on the sheet here, but can I just ask how things are going

in terms of Westmoreland Road and the school development there? Are you nearly ready to – 350

The Minister: Yes, the new Henry Bloom Noble School, Mr Chairman, is still on schedule. It is a couple of weeks behind but it will be finished during the summer holidays and those two old schools –

Q99. The Chairman: I was going to ask you … That was the next point. 355

The Minister: – will be coming in under that one banner. They are under one banner now:

Henry Bloom Noble School, but they physically will move into that one at the start of the Christmas term in September.

360

Q100. The Chairman: Do you have a plan for the sites at Ballacloan and Fairfield? The Minister: They will be offered around Government and then I presume the Strategic

Asset Management Unit will take control of those and do as they see fit. 365

The Chairman: Right. Prof. Barr: The Salvation Army is using Fairfield for, I think, a year but just as a temporary

measure. 370

Q101. The Chairman: Okay, good. What is the latest on pupil data? Prof. Barr: As in …? 375

The Minister: As in the central database? The Speaker: The central database. The Chairman: Yes, I think that is what I am being prompted on. 380

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The Minister: That, as we know, was turned on after I came back to Tynwald a couple of months ago. As a result of that coming back in now, certainly the educational psychologists have access to the information – and they were the ones that were most hard done by while that was turned off, while we were resolving the issue. It does mean that we have access back to the 385

information that we need – albeit in numerical terms and not by names – and we were getting before for the Department’s benefit.

The Chairman: Thank you. 390

Q102. The Speaker: Can I just ask you to confirm that the regulations governing providing information to parents in respect of data held in schools is to be updated to reflect the regulations passed this February in Tynwald, which gave the authority and the legal powers to the Department actually to hold and collect data that went beyond registration and admission: the new central pupil database, in effect. 395

The Minister: There was certainly a commitment given to Tynwald, Mr Speaker, that parents

would have access to that and to make sure that was updated and they were able to check it – if I am reading you right, sir.

400

Q103. The Speaker: Yes, I think the commitment was given in Tynwald that it was identified that the existing 2004 regulations would need to correspond with the widened data that the Department and head teachers are now allowed to hold and disclose and be required to disclose to parents.

405

The Minister: That commitment was given that the 2004 regulations would be updated, Chair.

Q104. The Speaker: Yes. Just for the record, I need the confirmation that that is happening. 410

The Minister: I am sure Mr Shipley is working on that. Q105. The Speaker: Yes. Thank you very much. As a general comment, the amount of data that the Department can now have the ability to

hold: huge amounts of soft data on children … In primary schools, you will be aware, you are 415

trialling a system called Arbor for collecting information, which is a huge amount of soft data. If it is improperly disclosed – and I think assurances have been given that it will only go where it needs to go and not be shared indiscriminately across Government departments … That getting an off-the-shelf system of data collection actually would not necessarily be appropriate in the Isle of Man. You need to make sure it is tailored for what the schools actually need, if you are 420

not to be swamped and do nothing but analyse data? The Minister: Yes, Mr Speaker, I am told that any information we are collecting is stuff that

we do need and, if there is stuff on Arbor that we never use, then so be it, but we will only be collecting information that we do need and do use. 425

Q106. The Speaker: And provision is made to dispose of it ultimately, presumably when it is

no longer necessary? The Minister: Yes, I think that was another commitment that I gave to Tynwald, sir. 430

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Prof. Barr: I would also say, Mr Speaker, that there is no intention with the Arbor system … This is an education system; there is no intention to share that information with other Government departments, which was also the question that you raised.

435

Q107. The Speaker: Because some of the information is potentially very sensitive: family information, ethnicity, potential safeguarding, child protection issues can be flagged up on that data and rightly be made available to those that need to see it.

Prof. Barr: Only those that need to see it and again it is heavily anonymised as well. I think 440

we do not take this lightly in terms of what we have with this system. It has now been rolled out across all our primary schools and we will see how it works.

Q108. The Chairman: Okay. Could I ask the Minister, do you have a view on whether the policy elsewhere in relation to 445

academies is one which you have considered? The Minister: We have discussed it, Mr Chairman. We certainly would not entertain it here.

What we have here, we are very happy with; it works and provides us with what we believe is a very good education system. We do not see any reason to change it. The views of visitors that 450

we have had here – whether they be unions or heads or teachers – is that what we have got backs that up, and there is no reason to change it.

Q109. The Chairman: Okay. Thank you. Are you satisfied with the process of schools’ evaluation and review? 455

Prof. Barr: Yes, the answer would be to that. Obviously we have that responsibility under

section 50 of the Education Act and we have what is called an SSRE process, all underpinned by common performance indicators. We have self-evaluation which takes place in our schools. We have link advisers who essentially are, in old money, school inspectors. We have two for the high 460

schools and four for the primary schools and they operate in cluster groups. We have external validation, which is done by an external company called WCL. They have

the final say on any disagreements between the schools or the Education Improvement Service on the outcomes of any reports that are made.

The other thing to note is our inspection process is significantly less expensive than Ofsted, 465

with the approximate cost of an Ofsted inspection being about £20,000, compared to the annual cost of our school inspector or school adviser, which is a salary with one cost of about £50,000. So the Ofsted inspection regime, if it was introduced here, would be significantly more expensive than the one we have currently got. I do not think it would yield any better results, quick frankly, in terms of what we have got. 470

Q110. Mr Boot: How many schools do you evaluate every year or do they all get evaluated

every year? Prof. Barr: We operate a process where they are all evaluated on a rolling programme. What 475

happens is that, if they have got a good inspection, there is a light touch. We have a capacity within the Department to actually put in additional special inspections and, from time to time, we have brought in special advisers or consultants from the UK, if we have had a particular concern over a particular issue within a school. That is also something that is available to Geoff Moorcroft who is the Director of Education; that is over and above our own internal processes. 480

The results of those, obviously, are published openly and are also presented to the Minister and political Members within the Department.

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Q111. The Speaker: Can I ask how you undertake independent external assessment of the Department’s own central services: special needs, psychology service, school meals, all the 485

centralised services that you do? Prof. Barr: Well, some of these things no longer sit with us, such as school meals which

obviously sits with Health, (The Speaker: Yes, of course.) as does IT with GTS. So, increasingly, a lot of those centralised services rest with other Government Departments, not with us. 490

I am struggling to think … In terms of special needs, that would be done within the inspection that would be done within the school. Where you have units that sit within the school, they would be included in that SSRE report.

Q112. The Speaker: Because quite a few years ago there was an Ofsted inspection done at 495

the Department itself, in the days when Ofsted went to schools. It was of the Department and its management, having regard to its role combining a local education authority and a department of state role rolled into one, and providing central services as well.

Prof. Barr: The central services would be checked in terms of how the schools view them, 500

because that would come up through the schools’ own inspection processes. In other words, how they felt they were being supported with regard to special needs and another things which are provided by the Department.

If you are suggesting we should have another independent departmental inspection, then that is something which the Department could consider. Obviously there would be a financial 505

cost attached to that, but I am satisfied, as Chief Executive of the Department, that if such an inspection took place that we would come out of it relatively well.

The Speaker: Okay, thanks. 510

Q113. The Chairman: What progress have you made with developing vocational qualifications? And, perhaps an add-on to that, how are you getting on in terms of working with the Department of Economic Development’s Education and Training Division, in terms of meeting the needs of the economy going forward?

515

The Minister: I can take the second question first, Mr Chairman. We have a very good working relationship with DED with regard to training and engineering in particular. The facilities that we have been able to provide over the last couple years, after Treasury and Tynwald have approved funding to us, we now have some very good opportunities for training in the engineering sector. 520

With regard to vocational training, we have now got all the five secondary schools – from 14 to 16-year-olds – working back with the College doing vocational training if they want to, and all schools are using that facility. I am not sure on the numbers that have taken that up, but it is certainly very, very good and it is looking good for the future.

525

Prof. Barr: I think I would add as well that we are trialling the Scottish Vocational Awards in both the College and some of our schools. We have an aspiration … The vision of the Department would be to have the International GCSEs – which by this time next year, 70% of our GCSE offer will be through Cambridge. Where it is not, it is through Northern Ireland or Wales, because they still have a letter grade system and we are very keen to keep an A through G 530

consistent letter grade system for all of our GCSE provision. Having said all that – and it is a huge piece of work and I think our teachers have done a

fantastic job operationalising a lot of this – we need to find a vocational offer that is innovative and works in a different educational way, because some of the Cambridge GCSEs are fairly traditional and they will not suit all learners. So we need to have a very innovative, vocational 535

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offer, and the Scottish vocational qualifications have received a lot of very good press, just quietly, in the Middle East and in the Far East and elsewhere.

We are working very closely with SQA in Scotland. We have a group of educational leaders: deputy heads, curriculum leaders, senior managers from the College, who are going up to Scotland very soon to meet senior education officials in Scotland. We have a couple of our 540

schools now who have been badged as centres for the SQA. We are still working with City & Guilds, Edexcel and those other areas where appropriate, but I think for us it is an exciting time in education. If we can get that innovative vocational offer to sit alongside a very stable GCSE offer, by and large badged through Cambridge, and then the other bit is the A-level offer where I think we need to be looking again at perhaps maintaining the AS and A2 – and that can be done, 545

again, through an international model – and then topped off by the university college. That is really the five-year vision, educationally, for the Department.

Q114. The Speaker: Where do you benchmark against? Given the changes in the UK, who do

you benchmark exam performance against? 550

Prof. Barr: This is something which is always difficult because we are a unique jurisdiction,

where we actually use different types of awards from different types of places. People sometimes think that when you say that you are trying to avoid those comparisons, but actually to make the comparisons, you have to make a number of adjustments to make them meaningful 555

because you are not actually comparing like with like. So, for example, something like the PISA reports are not useful to us because you have to have a minimum, as I understand it, of about 130 schools to participate in PISA. So people can roll out some of these things, Mr Speaker, and they are not necessarily things, (a) we can participate in or (b) that we can usefully measure ourselves against. 560

Having said that, we measure each school’s performance against each other on Island and over and above that we do look at the whole of the North West of England’s performance in terms of whether various education authorities are in the North West, in terms of their pass rates on GCSEs, A through C in English and maths or five GCSEs of any sort, A through C. Those are produced on an annual basis. We produce those tables, those figures. 565

All of that information is made available to the Minister and political Members. It is also made available to our schools. All of our high schools see each other’s results. So in that sense, that is where we are with this. We have no inclination to produce formalised league tables and with FOI coming up next year, the likelihood is that we will publish this information and, if people wish to create their own league tables or do something, then that will be for them. 570

Q115. The Speaker: I was going to ask: the expectation of a lot of parents new to the Island,

who are used to league table situations and moving into catchment areas where there is good performing schools and so on … Is it an issue for the Department? Do you get lots of queries of that sort? 575

Prof. Barr: No. The Minister: I have to say no we do not, Mr Speaker. No, it has never been an issue,

certainly in my three and a half years in the Department. I do not think we get too many through 580

the officers. Prof. Barr: No. I think we have had, in the almost three years I have been doing this role, one

parent who came in and wanted a very detailed explanation from the then secondary adviser, Paul Craine. They came in and spent a couple of hours and wanted to know about how the 585

numbers worked, etc. and we were happy to facilitate that.

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In terms of Members of Tynwald, we have always had an open invitation for any Member of Tynwald who wants to come in and look at those results. We are happy to explain them. I think it is the explanation and the context behind them that is important, because the raw numbers can often lead people into places that are misleading. 590

What I would say is that the Department’s GCSE results have improved 2% year on year for the last four years, and I think just to say to the Committee I would like to place on record my thanks to the teachers and schools for having done that. I think they have done a fantastic job at a time when there has also been significant curriculum reform and financial pressure.

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The Chairman: Would you like to …? Q116. Mr Boot: Yes, going back to the point that you made, Mr Chairman, about meeting the

needs of our employers for the future – in fact, we had a presentation in DED today about just that matter. As I see it, the heads at secondary level have a fairly autonomous way of dealing 600

with the curriculum they teach to. There is no centralised control, am I …? Now, does the Department issue any guidance or do they talk to DED and employers about what they need in terms of employees for the future; their qualification, vocational or academic? Is there any centralised link?

605

The Minister: As I said earlier, we have a very good relationship, through DED, with industry, whether it be through engineering, through e-gaming, IT and Chamber of Commerce. So we have very good relationships and we very much have our finger on the pulse, between us and DED, as to what is perceived as is out there.

Obviously, we cannot change anything at the drop of a hat. As Prof. Barr said, we like to 610

produce well-rounded children that are fit for the future and can adapt easily and quickly and are willing and capable to learn.

Q117. Mr Boot: But the point I am coming to is, if the heads are autonomous and academic

qualifications seem to be more aspirational than perhaps vocational-type qualifications that may 615

well assist in some sectors – and construction and retail are two of my sectors – and they seem to be perceived as not … They are last choice for some schools in terms of career projection.

Prof. Barr: What I would say is there has always been a perception and that is not necessarily

the fault of schools. Parents have great influence on children and young people as well and on 620

their choice of careers. The University College Isle of Man at one point was styled as ‘the little tech on the hill’.

The reality is that we have been on a journey over the last decade to show people just how important the skills and the educational elements are within that institution. We have also through time … The head teachers’ attitudes, I think, have changed – and we have certainly, 625

strategically, where we have had the opportunity when we make appointments … One of the key criteria we look at now is whether the head teacher is well aware of the importance of vocational education, of special needs education, and that the gold standard is not necessarily five As at A-level and a law degree from Cambridge. That is important and we need such people, but actually we need a range of people with a range of skills and they all ought to be equally 630

valued. The Department actually takes quite a dim view of anybody within the Department who has a different view from that.

Q118. Mr Boot: What I am trying to say is though, at the end of the day, if heads basically

determine their own curriculum and they do not get any direction from your Department, if you 635

are liaising with DED and you are aware, do you issue them any guidance?

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Prof. Barr: What happens is the DED should come through to the Department. There is a Department corporate plan which is approved by the Minister each year, with educational goals and targets within it, which includes vocational education. 640

I have to say, for example, University College Isle of Man would liaise very closely with DED and indeed with Treasury and Cabinet Office on the skill sets needed, and actually makes annual adjustments to its course offer and the number of students who are allowed onto courses based upon projected economic need.

Within the schools, we have extensive Junior Achievement involvement in our schools in 645

terms of employability. They are in all of our primary schools now, as well as in all of the high schools. We encourage employers to engage proactively with our schools. I think that is where we are with that.

In terms of Economic Development, increasingly we have meetings involving Chris Corlett, Jane Jelski, myself and others, and how we work together. There is a tension between Economic 650

Development and Education because obviously in many cases Economic Development are solely focused on particular skills for particular industries. That is not necessarily the goal of Education which, as the Minister has already said, is about producing individuals who have a broad range of skills, who are going to have to try and navigate through the next 40 or 50 years of employment. There is always going to be that little bit of friction between Economic 655

Development and Education on that basis. The Minister: There are certainly groups that meet between Education, Economic

Development and the heads of the College and the secondary heads. So any information like you are talking about, I believe, should be getting out and round there very quickly anyway. 660

Q119. Mr Boot: I think where we were coming from this morning is that we want to grow our

workforce and we want to retain our young people on Island, so we need to equip them with skills that are appropriate to the jobs that are either available or going to be available in the future. That is why I think there needs to be some joined-up thinking here. 665

The Minister: Just echoing what Prof. Barr just said, but also backing what I said earlier about

Tynwald’s investment in education over the last years through the training areas up at the College, whether it be engineering or through the building, it has been absolutely phenomenal. I welcome anybody to get in touch with myself or Prof. Barr if you want to have a look at the 670

facilities that are now available. We would be more than happy to show you round those. They are second to none within UK, Europe, I would suggest.

Q120. The Speaker: We might well take you up on – 675

The Chairman: Yes. We went to the prison recently so that would be interesting. The Speaker: A look at the College would be quite interesting. The Chairman: Very interesting. 680

The Minister: I am happy to do that. Q121. The Chairman: Can I preamble this next one by declaring an interest that my daughter

and son-in-law both work at this particular educational establishment. 685

There was an announcement in the Budget about Castle Rushen High School. What exactly is being done and how long will it take? And I have not been lobbied by either of them to ask that question! (Laughter)

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The Minister: How long it will take, Chairman, with regard to building a new school at Castle 690

Rushen High School? We are not too sure yet. Certainly we were very happy to see, this year, £50,000 go in for design fees to start the ball rolling down there. We will be trying to get that moved on as soon as possible.

We are very aware, as are the staff down there, about the condition of the school. I would have to say, at the moment, if I was to place a bet on it, I would say five to seven years before 695

that is completed – seven at the outside, I would hope. I would like to think we could do it quicker than that, but we are well aware that it is needed and will be the next major capital scheme within the Department.

Prof. Barr: It is something which is absolutely essential. We can demonstrate quite clearly 700

that Castle Rushen has had less infrastructure spend than any other high school on the Island over the last five, six, seven years and clearly this is something that we need to now address. Hopefully, as the Minister says, it will be a five-year project. It would be nice if it could be done even quicker than that. We are only at the design phase. We also have find what will be Castle Rushen’s uniqueness. We have a farm in Ramsey; we have some wonderful drama and 705

performing arts facilities at Ballakermeen. So what would we suggest at Castle Rushen? And funnily enough we were talking to David Hester yesterday about that in terms of engineering and Science, Technology, Engineering and Mathematics (STEM) subjects and in terms of other capital projects beyond that.

We are also planning a new STEM block at QEII. 710

The Chairman: Good. Q122. Mr Boot: What is the timescale on that? 715

The Minister: Again, that will be hopefully within the next three to four years. It is early days on that yet but we are being heavily lobbied by the head at QEII, every time we go to visit.

But if you want to have a visit, we will happily show you round if you have not already been there. That is probably the most antiquated part of the school now and needs updating very soon. 720

Q123. Mr Boot: I recently visited. The Minister: Yes, well you know what I am talking about. 725

Mr Boot: That is why I asked the question. Prof. Barr: We have acquired the land actually to make sure we have got the capacity to

make the building happen. That has already happened. Again, it is something that we wish to bring forward. 730

Those will be the two major high school projects over the next, I would say, three to five years.

Q124. The Chairman: In terms of your capital programme, anything else that features of any

significance? 735

The Minister: Those are the main two, I would suggest. There are always ongoing ones; most

of them will come in under the minor capital schemes, I would suggest, at the moment. I cannot think, off the top of my head, of any others.

740

Prof. Barr: The completion of Henry Bloom Noble, obviously.

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The Minister: We just spoke about … Prof. Barr: Then we have what we might do about St Thomas’, which is the other Victorian

school that is really not … That is definitely a school that has done more than its fair share as far 745

as Government expenditure. So we would like to see if we could find a solution to that in terms of ensuring that school is brought into the 21st century from the 19th century.

Q125. The Chairman: Okay. How about rural primary schools or other primary schools: any plans to close any of them? 750

The Minister: Certainly not to close them, Chairman! As you will know and we have discussed, the bringing together of Fairfield and Ballacloan

under the Henry Bloom Noble – that would be the only way I would foresee closing any other schools. It would be the joining of, if we were to produce a new school somewhere to take in 755

two schools, but there is certainly no envisaging within the Department to close any schools for any financial reasons or whatever at this time.

Prof. Barr: I think I would add to what the Minister is saying in the sense that Government, as

far as I am aware, still has an aspiration to grow the population to 100,000, but Government 760

cannot tell me where those additional 15,000 might live. Until we have something that is definitive in that regard, then I think it would be unwise to close existing schools on that basis.

I think over and beyond that the problem is, if you close a school … Supposing you close Ballaugh Primary School, all that would happen is the children would have to be sent to Michael or they would have to be sent up to Sulby. Those schools would then be at or above capacity 765

and then we would have to enter the situation of having to build additional infrastructure. The school then has a bigger footprint, so therefore the utility costs are higher; the school roll goes up, therefore, you have more senior management posts in the school and you have to then pay the head teacher more money.

So actually, although people look at a budget line and say, ‘Oh, you close that school and you 770

yield the following savings’, in reality the portion of savings is quite a small percentage in some of those cases, and you are certainly then in a position where you might also have to have additional capital spend.

The Department did model all of this about a year and a half ago. If Government was serious about this, then you would have to close all single-form-entry schools on Island, have dual-entry 775

schools, and that in essence could wipe out: Arbory, Ballasalla, Dhoon, Andreas, Juby, Foxdale. There are a significant number of schools and I think it is the judgment of the Department that there is no political or community will to go in that direction.

Q126. The Chairman: You nearly made Mr Speaker choke on his water! (Laughter) 780

No, I had heard a rumour some time ago – and you know what these rumours are – about Scoill Phurt le Moirrey, for example; that the Department was looking at that. But there was nothing in that?

The Minister: Absolutely not, Chairman. 785

The Chairman: Good. Okay, anything you would like to …? Q127. The Speaker: Recruitment and retention of staff and how you are dealing with teacher 790

shortages. What is the biggest problematic subject area for you at the moment?

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Prof. Barr: The only area that we have no issues with are PE teachers. (Laughter) PE teachers: we do not have a problem in that area. The secondary heads tell me that actually they probably could do with teachers in every other subject area, in either one or other of the schools across 795

the Island. We are bringing forward proposals to try and counter the academy approach in England

where, of course, increasingly academies are setting their own rates of pay. They are able to produce signing-on bonuses and incentivise people by paying off student debt. The sort of archetypal story you get is – which apparently is true – of someone with a first in physics who 800

had all of their university debt paid off and was given a signing-on fee of £30,000 to join a high school in England.

We are not going to be going down that route, clearly, because we cannot afford that, but we need to find a way of perhaps encouraging local people who are doing PGCEs or Cert Eds … We are thinking about bursary schemes or possibly offering the opportunity that, if we pay for this, 805

such individuals would come back and give four or five years educational service to the Island. We are looking at a number of those options.

The other option, of course, is the pension option which we can do nothing about in the sense that, after five years, if you return to UK you do so as a new starter. That has always been a disincentive for people to come from the UK into teaching on Island. 810

The other issue for people at the beginning of their career is still the house prices. I certainly still think that, both for Health and Education, there is probably a case for a return to looking at key worker housing for people at the beginning of their career which was, I understand, a policy the Island did have some 20 years ago.

815

Q128. The Speaker: At one time, the Department was targeting, for teacher recruitment, specific parts of the UK that had comparable house prices so that there was not a problem.

Are you saying there is no shortage of science teachers? There used to be. Prof. Barr: No, no. PE, as in physical education. 820

The Speaker: Yes. The Minister: I think Prof. Barr said the only area we do not have any issues is PE. 825

The Speaker: Oh, I see. Prof. Barr: Physical education is the only one where – The Speaker: I misheard you, sorry. 830

Prof. Barr: If you talk to the five secondary heads, the only thing they say is, ‘We are okay at

the moment for PE teachers, but we can take pretty much anything else.’ Q129. The Speaker: A significant difference! Yes. 835

Induction of teachers and the Manx curriculum: they are statutorily obliged to deliver history, language and culture? How do you do that across the subjects when you are relying on UK and external teachers? How do you ensure that they have an understanding of Manx culture and history?

840

Prof. Barr: We do not really do anything formal in terms of an induction with that in mind when new teachers join the Department. That is an interesting idea in terms of what we might do.

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Q130. The Speaker: It used to be that teachers had a programme which included a visit to a 845

Tynwald sitting. They were given an introductory talk about Manx history. Prof. Barr: I certainly think that – Q131. The Speaker: That has been long-gone, has it? 850

Prof. Barr: Yes, that is not something I have ever been aware of, that we have done in my

time at the Department. I think it is an interesting idea. Q132. The Speaker: I think that is something that could be looked at; it is not terribly 855

expensive to deliver. You get your incoming batch of teachers in the Autumn who sit through a Tynwald session for a morning and see if they return. (Laughter)

The Chairman: I thought we were trying to keep them! 860

The Minister: I am glad you said that, Chairman. The Clerk: There is plenty of room in the public gallery! The Minister: It is certainly something, Mr Speaker, we are happy to look at. Certainly in my 865

time in the Department I have never known that, so it is obviously something that was there but is not there anymore.

The Speaker: It was obviously four Education Ministers ago, when I was young. 870

Q133. The Chairman: But you have engaged Jo Callister, so you have got a good enthusiast in terms of the Manx?

Prof. Barr: We do and she does some excellent work with our primary colleagues, and I think

there is some excellent embedded work done in our primary schools on local history, culture – 875

Q134. The Chairman: Much more than is recognised, I think. Prof. Barr: Yes there is a lot more that goes on than people think, in music and art and history

and folktales. 880

Q135. The Chairman: I think we are about at the end. Anything else you have? The Speaker: No, that is fine. 885

Mr Boot: Nothing else, sir. Q136. The Chairman: Then, can I thank you very much for coming along and so helpfully

answering all our questions. 890

I formally say that the Committee will now sit in private. Thank you very much. The Minister: Thank you, Mr Chairman. Can I just say, we will get back in touch with you with

regard to a visit to the College and any other facilities you would like to see. 895

The Chairman: Yes, that would be welcome.

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The Minister: I will happily do that for you. Thank you. The Speaker: Excellent. Thank you. 900

The Chairman: Thank you.


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WRITTEN EVIDENCE

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Appendix 1: Letter from Mark

Charters 12th February 2015 – Postion

of Department regarding means

testing for Public Sector Rents

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191191

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Appendix 2: Tynwald Written

Answer 45 of 13th December 2011

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TYNWALD COURT, TUESDAY, 13th DECEMBER 2011

_________________________________________________________________ 253 T129

Under such agreements, mineral operators are required to complete half-yearly royalty statements, issued by the Department at the end of May and November respectively. Such 3105 statements confirm the tonnage of mineral sold during the respective royalty period. Hence, the Department has a record of all building stone produced and sold on the Island. Royalty statements over the past three years have been examined and the total declared sale of building stone tonnages are as follows:

3110 Year ending May 2009 1,677 tonnes Year ending May 2010 1,593 tonnes Year ending May 2011 1,174 tonnes It is assumed that most building stone extracted from Manx quarries is used by the local 3115

construction industry, although Pooil Vaaish Quarry has a long history of stone exports. (b) It is not known how many tonnes of building stone are imported into the Island, although

the Department has recently been advised that approximately 400 tonnes is imported per month, c. 4,800 tonnes per annum.

(c) Earystane, Starch Mill, Cringle and Pooil Vaaish quarries currently operate under Mining 3120 Agreements issued by the Department. Historically, building stone has also been supplied from the former Dreemskerry Quarry and South Barrule Quarry; however, neither of which have operated over the past three years. It is important to recognise that the Mining Agreements allow the quarries to not only extract building stone but to also produce various forms of aggregate from the off-cuts and any waste material that is not suitable for use as building stone. Of the current 3125 building stone quarries, only Earystane focuses primarily upon the production of building stone.

(d) Each Mining Agreement contains a specified permitted annual extraction limit which varies from quarry to quarry as a result of a combination of factors. Extraction limits cover all quarry products, not just the tonnage of building stone. The tonnage of building stone as a proportion of the annual permitted extraction limit also varies from site to site, largely based on the nature of the 3130 stone and the prevailing geological conditions. For the past three years, annual extraction limits have not been met by any of the aforementioned quarries.

(e) Following a Planning Inquiry in September 2008 held to consider the former Department of Local Government and the Environment’s decision to refuse planning permission for an extension of Dreemskerry Quarry in 2006, the Inspector appointed to preside over the Inquiry advised in his 3135 Report to the Council of Ministers that the Department of Local Government and the Environment should look to produce an all Island Minerals Strategy. The Department of Infrastructure is, therefore, currently considering the scope and form of such a strategy.

The Department of Economic Development has produced and continues to update a Minerals Resource Plan. This document is a report on the Island’s general geology; sets out where minerals 3140 are likely to occur; indicates the extent of mineral reserves which have valid planning permissions for extraction; assesses past demand for minerals and attempts to forecast future mineral demand. The Mineral Resources Plan has been used extensively in the past by quarry operators as a source of information when preparing planning applications for mineral extraction. It is envisaged that once the Island’s Minerals Strategy has been adopted, the Mineral Resources Plan will continue to 3145 be used as a source of information on the Island’s mineral resources.

EDUCATION AND CHILDREN

Centralised pupil data system Purpose; numbers; costs; data protection

45. The Hon. Member for Garff (Mr Speaker) to ask the Minister for Education and Children: In respect of the Department’s centralised pupil data system: (a) what the purpose is of holding records of all school children and their parents on a centralised pupil data system within the Department; 3150 (b) what the current total number of people is on the centralised pupil data system, including all pupils, parents and guardians; (c) what the cost was of setting up this centralised pupil data system; (d) what the annual running cost of the centralised pupil data system is; (e) whether a system of role-based access control has been set up within the Department to 3155 ensure the centralised pupil data system complies with the Data Protection Act;

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_________________________________________________________________ 254 T129

(f) if he will consent to allowing the Data Protection Supervisor to audit the processing of data within the centralised pupil data system for good practice; and (g) if he will publish the details of any internal audit his own Department may have made of the centralised pupil data system? 3160 Answer: (a) Currently, the Department is reliant upon individual schools to supply limited,

decontextualised data to the Department. This is gathered in sections, e.g. we have month by month attendance data by school and we have attainment data by cohort in each school. This allows us to take some very generalised views of quality and outcomes, but does not, for example, 3165 allow us to investigate and intervene across the piece on the impact of attendance on achievement, cohort and school differences etc. The database will also allow us to make evidence based decisions on the effectiveness of provision for a range of groups, e.g. looked after children, children with disabilities, low level SEN, youngest children in cohort, achievement of pupils with entitlement to free school meals etc. 3170

We have struggled to make evidence based decisions other than at single school level and have not been able to set policy based on evidence as well as we could.

A further example would be: is there any evidence on the IOM to indicate higher achievement for pupils who have attended Department funded pre-school?

Single System – In addition the data will be more secure on this system. The information on 3175 parents will be limited to the information currently gathered in schools.

Furthermore, early intervention will be enabled to its fullest extent with automated triggers. For example, a student whose attendance falls below a specified limit would generate an e-mail to intervention groups who would be able to act instantly upon the live information.

The Department have a number of services that support students in our schools, SEN, 3180 Education Liaison Officers etc. These services will centralise their case management for specific pupils onto this single database. This enables the Department to hold a single, accurate picture of students in our care.

Finally, no information on parents or carers will be extracted from the school systems. This data will remain in the schools where it was initially gathered. 3185

(b) Details of data in Synergy at the moment (still in test phase only two schools currently involved):

Onchan 415 pupils 3190 No parent/guardian data One contact for school (Headteacher with contact details as for school) CRHS 842 pupils 3195 No parent/guardian data One contact for school (Headteacher with contact details as for school) (c) £267,500. (d) Annual running costs £44k. 3200 (e) Yes, a system has been devised and discussed with the Data Protection Supervisor, who has

advised that this meets requirements. (f) Yes. (g) No audit carried out, as still in test phase.

HEALTH

Dr D H Hoehmann Value of work done at Hospital

46. The Hon. Member for Douglas South (Mrs Beecroft) to ask the Minister for Health:

During the time that Dr Dirk Heinz Hoehmann was employed as a consultant at Noble’s 3205 Hospital – (a) whether Dr Hoehmann’s work at the Hospital was satisfactory;

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Appendix 3: Letter from Chamber of

Commerce 9th December 2015 –

Information regarding Idenfication

Checks at ports

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VISITOR ECONOMY COMMITTEE

Mr S. Rodan SHK

Tynwald Scrutiny Committee Legislative Buildings Finch Road Douglas IM1 3PW 9th December 2015 Dear Mr Rodan, It was reported recently that the Home Affairs Minister advised the Tynwald Scrutiny Committee that ID checks are completed in the Channel Islands and Ireland. Assuming this information to be correct, the Visitor Economy (VE) Committee of the Isle of Man Chamber of Commerce have a number of concerns. The Committee has not been consulted on this issue and we would like to clarify that ferry services from the UK to the Channel Islands do not require ID for travel. There is no requirement for passports to be checked for border control purposes on any travel between the UK, IoM, Channel Islands, or the Republic of Ireland. Indeed, there is no Government requirement for passengers on these services to possess a passport. Airlines check passports for revenue protection and security reasons but neither scenario is replicated on ferries. While the VE Committee understands there may be some political advantages in imposing checks, the Committee is concerned about the possible reduction in Visitor numbers if ID controls were imposed in the Isle of Man, for the following reasons;

17% of UK residents do not possess a passport (source UK Govt)

UK Govt advises residents to allow 6 weeks for passport applications. o c.55% of IOM ferry travel is booked within 6 weeks of the date of travel

A significant proportion of visitors to IOM could choose alternative destinations if IOM were to be perceived as less convenient and even a small reduction in Visitor numbers would be devastating for many IOM VE businesses

IOM port facilities in UK are physically confined and there are no existing suitable facilities in the UK for ID checks

Checking ID for up to 800 ferry passengers would lengthen check-in times all year, and particularly at events if motorcyclists are required to remove their helmet

Longer check in times at TT would reduce TT service frequencies and therefore have a likely adverse impact on visitor numbers

Yours sincerely, Sara Richards Chair, VE Committee, Isle of Man Chamber of Commerce

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Appendix 4: Email from the Minister

of Home Affairs 15th February 2016 -

Idenfication Checks at ports

209209

210210

From: Juan Watterson

Sent: 15 February 2016 16:38

To: Jonathan King

Cc: Lalor-Smith, Julian; Kelly, Mark (DHA)

Subject: SAPRC - ID checks

Dear Jonathan

Thank you for your e-mail seeking clarification re the conflicting statements, re requirements for ID onferries within the British Isles directed to Mark Kelly.

The fact is that the situation is rather confusing and the Ferry Operators do in varying degrees according totheir web sites either require ID or advise that ID should be carried. The exception being P&O which has nosuch requirement or advice on its web site but does require ID on its Liverpool to Dublin route

The factual position, provided from the major Ferry Operators Web Sites is as follows:-

Stena Line - British or Irish citizens travelling on our Irish Sea routes do not need a passport to travel toBritain or Ireland but are advised to take a form of identity.Irish Ferries - Recommend all passengers bring a passport with them. Irish and British citizens do notstrictly require a passport to travel between the two countries - some form of identification is howeverrequired.Condor Ferries - If you are travelling between the UK and the Channel Islands, then your passport is notneeded. However, we recommend that you have a suitable proof of identity with you when you travel.P&O Ferries - British or Irish nationals do not need a passport to travel between the UK and Ireland,however, photo ID is required for all adults 18 & over on the Liverpool-Dublin route only.*(4 major operator’s web sites were examined).

It is likely that most passengers examining the web sites except P&O would be left with the impression theyshould carry ID whilst traveling with the major ferry operators in the British Isles.

Therefore, it is correct to say that on some ferry routes in the British Isles ID is required, in others ID isrecommended, and in the case of one ferry Operator it depends which route you are travelling as to whetherit is a requirement or not.

There is little doubt the web based advice for passengers is very confusing, on which my brief was based,and it is therefore understandable that there are different interpretations on what is required, but what iscertain is that Irish Sea Ferries do require ID on all its routes as does P&O on its Liverpool to Dublin Route.In addition all but P&O recommend carrying ID and even P&O when contacted by telephone recommendedID be carried for use at the destination.

I very much hope the above provides the clarification required to what is a rather confusing situation and Ivery much appreciate your bringing this important matter to my attention.

Kind regards

Hon. Juan Watterson BA(Hons) FCA MHKMember of the House of Keys for RushenMinister - Department of Home AffairsChairman - Communications CommissionIsle of Man Armed Forces Champion

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Kind regards

Hon. Juan Watterson BA(Hons) FCA MHKMember of the House of Keys for RushenMinister - Department of Home AffairsChairman - Communications CommissionIsle of Man Armed Forces Champion

Isle of Man. Giving you freedom to flourish

WARNING: This email message and any files transmitted with it are confidential and may be subject to legal privilege. You must not copy or deliver it to anyother person or use the contents in any unauthorised manner without the express permission of the sender. If you are not the intended addressee of this e-mail, please delete it and notify the sender as soon as possible.

No employee or agent is authorised to conclude any binding agreement on behalf of any of the Departments or Statutory Boards of the Isle of ManGovernment with any party by e-mail without express written confirmation by a Manager of the relevant Department or Statutory Board.

RAAUE: S’preevaadjagh yn çhaghteraght post-l shoh chammah’s coadanyn erbee currit marish as ta shoh coadit ec y leigh. Cha nhegin diu coipal ny cur ehda peiagh erbee elley ny ymmydey yn chooid t’ayn er aght erbee dyn kied leayr veih’n choyrtagh. Mannagh nee shiu yn enmyssagh kiarit jeh’n phost-l shoh,doll-shiu magh eh, my sailliu, as cur-shiu fys da’n choyrtagh cha leah as oddys shiu.

Cha nel kied currit da failleydagh ny jantagh erbee conaant y yannoo rish peiagh ny possan erbee lesh post-l er son Rheynn ny Boayrd Slattyssagh erbee jehReiltys Ellan Vannin dyn co-niartaghey scruit leayr veih Reireyder y Rheynn ny Boayrd Slattyssagh t’eh bentyn rish.

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Isle of Man, IM1 3PW

British Isles May 2016

Tel: 01624 685520

Fax: 01624 685522

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